JOHNA.SEAVERNS 


Webster  Family  Library  of  Veierinary  Medicine 
Cummings  School  of  Veterinary  IVledicine  at 
Tutts  University 
200  Westboro  Road 
North  Grafton,  MA  01 536 


Special  Veterinary 
Therapy 


By  Mart  R.  Steffen,  M.D.C.,  V.S. 


CHICAGO 

American  Journal  of  Veterinary  Medicine 

1914 


7M7 

m 


Copyright,  1914 

By, 

D.  M.  CAMPBELL 


Contents. 


Muscular   Atrophy 7 

Synovial   Distention 9 

Rapid  Reduction  of  Hygromas 11 

Fistula  of  the  Withers 13 

Wire-Cuts — Lacerated    Injuries 17 

Open    Joints 19 

Chronic    Laminitis 23 

Hyperesthesia  of  the  Neck 25 

Chronic    Eczema,    Scratches,    Grease    Heel 29 

"Cracked"  Heels  in  Track  Horses 31 

Prolonged  Analgesia  in  Ophthalmia 33 

Specific  for  Infectious   Entero-Hepatitis   in   Fowls 35 

Occlusion   of   the   Lachrymal   Ducts 37 

Choke   in   the   Horse 39 

Hemorrhage  from  the  Palatine  Artery 43 

Shortening   the    Duration    of   Parturient    Paresis 47 

Obstetrical   Paralysis   in   the   Cow.... 49 

Protracted    or   Prolonged    Colics 51 

Intravenous    Medication 53 

Subspinal  Anesthesia  for  Abdominal  Operations 55 

The  Treatment  of  Tetanus  with  Passiflora  Incarnata 59 

Contagious    Abortion    in    Cattle 61 

Choke  in   the   Ox 65 

Paraplegia   following  Canine  Distemper 69 

Treatment  of  Pneumonia  with  Sparteine  Sulphate 73 

Creosote  for  Intestinal  Infections 75 

Retained  Secundines  in  Cows 77 

Latent,  Imbedded  Foreign  Bodies 79 

Botryomycosis  81 

Chronic  Edema  of  the  Hind  Extremities — Stocking 86 

Pulmonary    Emphysema — "Heaves"    87 

Neglected  Medicinal  Agents  in  Veterinary  Medicine  89 

Stock  Colic  Mixtures  93 

Castration   of   Pigs    Having   Scrotal    Hernia 95 


Fat  paunches  have  lean  pates;  and  dainty  bits. 
Make  rich  the  ribs  but  bankrupt  quite  the  rvits. 

Shakespeare. 


Introduction. 


This  collection  of  therapeutic  notes  and  clinical  cer- 
tainties has  been  gotten  together  as  the  result  of 
more  than  ten  years  of  active  practice,  during  which 
period  the  writer's  personal  experience,  as  well  as 
his  deductions  from  the  work  of  others,  has  been 
drawn  upon  and  collated  for  the  purpose  of  publica- 
tion. 

No  system  of  medicine  is  upheld  in  this  treatise; 
nor  are  the  pathological  or  other  technical  phases  of 
veterinary  science  given  preference  over  the  procedures 
of  a  definitely  practical  character,  even  though  the  lat- 
ter border  on  the  empirical.  The  end-result,  the  ability 
to  relieve  or  cure,  receives  first  consideration  through- 
out the  entire  volume. 

While  the  book  will  be  most  valuable  to  the 
recent  graduate,  it  is  confidently  hoped  and  believed 
that  it  can  also  be  used  with  profit  by  those  who  have 
long  been  engaged  in  practice. 

The  writer  will  be  pleased  to  receive  comments, 
criticisms  or  additions  for  possible  incorporation  in 
future  editions. 

Brillion,  Wis.  Mart  R.  Steffen. 

December,  1914. 


Muscular  Atrophy. 

Muscular  atrophy  usually  comes  to  the  attention 
of  veterinarians  as  a  secondary  affection,  following 
laminitis,  injuries,  azoturia  or  as  the  result  of  pro- 
longed lameness  in  one  or  more  limbs.  Cases  of 
muscular  atrophy  from  central  brain  or  spinal  cord 
lesions  are  almost  unknown  in  veterinary  patients. 

For  all  cases  of  confirmed  muscular  atrophy, 
whether  accompanied  by  lameness  or  not,  we  have  in 
turpentine  a  panacea. 

It  is  of  importance  to  select  only  cases  in  which 
the  inflammatory  process  in  the  muscle  itself  has  sub- 
sided. In  other  words,  atrophy  must  be  confirmed 
and  all  evidence  of  inflammation  must  have  disap- 
peared before  applying  this  remedy. 

For  this  condition  we  use  the  rectified  oil  of  tur- 
pentine, injecting  it  subcutaneously  with  a  hypoder- 
mic syringe  at  several  places  in  the  upper  half  of  the 
atrophied  area.  About  five  minims  at  each  place  are 
sufficient  if  the  rectified  oil  is  used,  and  at  least  one 
injection  should  be  made  at  the  extreme  upper  border 
of  the  affected  area. 

In  high-strung  animals,  it  produces  considerable 
irritation  and  they  may  paw  violently  for  eight  or  ten 
hours,  at  the  end  of  which  time  the  area  is  immensely 
tumefied. 


8  SPECIAL  VETERINARY  THERAPY 

This  tumefaction  is  gradually  disseminated  over  a 
much  larger  area  and  is  then  slowly  absorbed.  In 
from  two  to  three  weeks  no  trace  of  it  is  left  and  in 
its  stead  good,  solid  muscular  tissue  is  appearing. 
During  this  time  the  patient  must  have  exercise,  the 
best  being  a  couple  of  weeks'  run  on  pasture.  If  this 
is  not  convenient,  light  work  should  be  given. 

Much  of  the  effect  of  the  treatment  is  lost  if  the 
animal  is  idle  during  this  time.  If  work  is  given,  it 
should  not  be  begun  until  the  third  day  after  the  in- 
jections. 

No  abscess  formation  occurs  if  the  rectified  oil  is 
used  and  the  injection  is  aseptically  made.  In  occa- 
sional cases  some  of  the  punctures  may  "point,"  but 
when  they  break  or  are  incised  it  will  be  found  that 
they  contain  only  serum.  If  a  pure  rectified  oil  is 
used  subcutaneous  injection  is  ample.  Intra-muscu- 
lar  injection  is  not  satisfactory  and  entirely  uncalled 
for.  Abscess  formation  always  follows  intra-muscu- 
lar  injection  and  it  does  not  accomplish  enough  addi- 
tional good  to  offset  the  disagreeable  features  which  it 
embodies. 


Synovial  Distention. 

These  conditions  occur  in  the  various  regions 
where  synovial  bursae  are  lodged  and  are  frequently 
of  such  size  as  to  detract  from  the  market  value  of 
the  animal.  Many  of  these  enlargements  occur  with- 
out apparent  inflammatory  disturbance  and  seem  to 
be  due  chiefly  to  an  over-active  condition  of  the  syno- 
vial membrane.  In  cases  exhibiting  positive  inflam- 
matory signs,  lameness  is  usually  present.  The  treat- 
ment of  these  cases  varies  with  the  location  and 
severity  of  the  lesion. 

The  cases  which  are  under  discussion  in  this 
article  are  those  ''puffs"  of  various  kinds  which  come 
to  the  practitioner  because  they  are  "eye-sores"  on 
the  animal,  detracting  from  his  appearance  of  sound- 
ness and  from  his  value  as  a  marketable  animal.  Lame- 
ness is  seldom  present.  For  these  cases  we  have  in 
the  following  operation  a  simple  and  satisfactory  treat- 
ment. 

The  operation  is  performed  at  the  lowest  point  in 
the  swelling,  where  an  area  of  a  square  inch  or  two 
is  shaved  and  thoroughly  disinfected. 

An  aspirating  needle  is  introduced  and  the  con- 
tents of  the  sac  are  drawn  out  to  the  last  drop.  When 
this  has  been  accomplished,  the  aspirating  needle  is 
carefully  withdrawn  and  a  very  fine  hypodermic 
needle  is  inserted  at  a  considerable  slant  through  the 


10  SPECIAL  VETERINARY  THERAPY 

skin;  it  must  not  be  pushed  through  the  skin  at  right 
angles  to  it. 

For  the  next  step  in  the  operation  an  ordinary  rub- 
ber bulb  and  fine  hose  or  a  milk-fever  outfit  will  suf- 
fice. The  rubber  tubing  is  attached  to  the  head  of  the 
hypodermic  needle  and  the  cavity  is  inflated  tensely 
with  air.  When  enough  air  has  been  pumped  in,  the 
needle  is  quickly  withdrawn  and  pressure  is  made  on 
the  seat  of  puncture  for  a  few  minutes  with  the  fin- 
gers, after  which  a  dressing  of  iodoform  and  collodion 
is  applied.  If  the  needle  has  been  carefully  intro- 
duced on  a  slant,  no  air  will  come  through  the  punc- 
ture. 

The  results  are  obtained  by  the  pressure  which  is 
exerted  by  the  air  on  the  cells  of  the  synovial  mem- 
brane, producing  a  degree  of  atrophy  which  inhibits 
excessive  synovial  secretion. 

The  air  becomes  absorbed  in  from  twelve  tO'  eigh- 
teen hours.  The  patient  should  be  kept  quiet  for  a 
week.  If  the  distention  has  not  disappeared  satisfac- 
torily after  the  third  week,  the  treatment  should  be 
repeated. 


Rapid  Reduction  of  Hygromas, 

In  contra-distinction  to  the  various  forms  of 
"puffs"  or  synovial  distentions  discussed  in  the  pre- 
ceding article  are  the  various  hygromas  that  present 
features  of  genuine  unsoundness. 

While  their  location  is  always,  like  the  various 
puffs,  at  the  seat  of  a  synovial  bursa,  we  find  here  a 
real  structural  change.  The  bursa  has  been  subjected 
to  a  severe  bruise  which  has  resulted  in  the  forma- 
tion of  a  solid  mass  of  fibrous  tissue. 

The  most  common  hygroma  is  that  occuring  on  the 
point  of  the  elbow  and  commonly  termed  a  "shoe- 
boil."  The  proper  surgical  operation  for  these  is,  of 
course,  complete  extirpation  with  the  knife.  How- 
ever, as  this  operation  makes  absolutely  necessary  a 
long  period  of  rest,  during  which  time  the  owner  is 
deprived  of  the  use  of  the  animal,  it  is  often  imprac- 
ticable or  at  least  possesses  serious  disadvantages. 
It  is  often  highly  desirable  to  remove  or  reduce  these 
enlargements  with  the  patient  doing  daily  work.  For 
such  cases  and  for  all  hygromas,  in  fact,  the  following 
treatment  is  a  very  satisfactory  proceding.  The  re- 
sults are  prompt  and  lasting  and  the  animal  can  work 
while  under  treatment. 

An  area  sufficiently  large  is  shaved  and  thoroughly 
disinfected  at  the  proper  seat  for  lancing  the  tumor. 
All  hygromas  contain  in  their  centre  a  cavity  filled 

11 


12  SPECIAL  VETERINARY  THERAPY 

with  degenerated  synovia  and  occasionally  some  pus. 
The  tumor  is  now  incised  for  drainage,  making  a 
fairly  large  opening.  The  contents  are  forced  out 
completely  by  compressing  with  the  fingers  and  then 
an  ounce  or  two  of  tincture  of  iodine  is  injected  and 
allowed  to  run  out  again  immediately.  Following 
this  a  rapid  reduction  of  the  tumor  is  brought  about 
by  the  use  of  Fibrolysin  (thiosinamine  salycilate), 
made  by  Merck  &  Co.,  and  marketed  in  ampules  con- 
taining about  3cc  each. 

One  injection  is  made  as  soon  as  the  tumor  has 
been  lanced  and  thereafter  every  two  or  three  days. 
Two  ampules  are  used  at  each  treatment,  injecting  it 
hypodermically  at  various  points  around  the  base  of 
the  tumor.  Fibrolysin  has  a  selective  action  on 
fibrous  tissue  and  is  of  no  value  in  enlargements  of 
other  tissues  or  organs. 

A  satisfactory,  sometimes  a  complete,  reduction 
of  the  hygroma  can  be  obtained  in  the  course  of  two 
to  three  weeks  depending,  of  course,  on  its  size. 


Fistula  of  the  Withers. 

This  is  a  condition  which  requires  the  exercise  of 
the  best  surgical  judgment  on  the  part  of  the  veter- 
inarian. It  is  just  as  important  for  the  operator  to 
recognize  those  cases  which  require  a  radical  surgical 
operation  and  the  complete  extirpation  of  the  diseased 
parts  as  it  is  to  recognize  the  case  in  which  ordinary 
drainage  will  suffice  to  effect  a  cure. 

The  guide  in  these  cases  is  the  amount  of  tume- 
faction which  is  present  and  the  nature  of  this  tume- 
faction. First,  I  desire  to  say  that  those  cases  which 
require  radical  interference  are  rare.  Seventy^five 
per  cent  of  all  cases  of  fistula  of  the  withers  are  cur- 
able through  the  establishment  of  proper  drainage  and 
the  application  of  remedies  to  terminate  necrotic  ten- 
dencies. A  possible  addition  is  bacterin  therapy  but 
this  is  reliable  and  of  real  value  only  if  the  bacterins 
are  autogenous.  Many  cases  of  fistula  of  the  withers 
are  distinctly  of  pneumococcic  origin. 

The  treatment  of  fistulous  withers  consists  of 
either  radical  surgical  removal  of  all  necrotic  tissue 
or  of  the  establishment  of  proper  drainage  only. 

The  first  class,  those  for  radical  operation,  con- 
sists of  only  those  rare  cases  in  which  the  withers 
are  immensely  tumefied  with  little  or  no  discharge. 
In  such  cases  incision  is  made  on  the  median  line  and 
the  entire  mass  of  necrotic  tissue,  down  to  the  last 

12 


14  SPECIAL  VETERINARY  THERAPY 

shred,  is  fearlessly  dissected  out.  The  surgeon  must 
rely  on  his  own  ingenuity  in  controlling  the  profuse 
hemorrhage  which  always  occurs  and  can  not  be 
avoided. 

The  rapidity  with  which  recovery  takes  place  after 
this  procedure  depends  upon  how  thoroughly  the 
necrotic  area  is  cleaned  up  and  upon  the  after-treat- 
ment. 

The  after-treatment  in  these  cases  should  consist 
in  packing  the  cavity  daily  with  sterile  gauze,  and 
only  such  irrigation  or  washing  as  is  absolutely 
needed.  During  this  time  tonics  should  be  given  and 
the  horse  should  be  kept  as  quiet  as  possible.  Occa- 
sional swabbing  with  tincture  of  iodine  helps  to  hasten 
granulations. 

The  radical  operation  for  fistulous  withers  is  far 
from  being  a  scientific  or  pleasant  operation ;  it  is  to 
be  used  only  in  cases  which  demand  it.  Again,  such 
cases  are  rare.  In  most  cases  drainage  and  proper 
medical  care  effect  a  cure  in  a  reasonable  time  and 
ordinarily  this  is  the  only  satisfactory  method  in  gen- 
eral practice  where  hospital  care  is  not  available. 

There  are  not  many  cases  in  which  drainage,  proper 
drainage,  can  not  be  obtained.  The  point  to  select 
for  making  an  opening  to  drain  the  withers  is  always 
at  the  conjunction  of  the  normal  level  and  the  tumefac- 
tion. This  means  that  the  mouth  of  the  opening  is 
always  in  healthy  tissue.  Therein  lies  the  secret  of 
cure  of  fistula  of  the  mithers  by  drainage.  At  first 
thought,  this  appears  a  simple  matter,  but,  for  me,  it 
requires  considerable  study  and  careful  examination 


FISTULA  OF  THE  WITHERS  15 

in  every  case  to  pick  out  this  decidedly  limited  area. 
The  incision  must  then  run  horizontally  and  must  be 
at  least  two  inches  wide  through  skin  and  underlying 
musculature.  From  this  incision  a  stab-wound  is  then 
made  through  the  tumefied  parts  running  obliquely 
upwards  towards  the  normal  apex  of  the  withers,  not 
stopping  until  the  top  is  reached  just  under  the  mid- 
dle line.  (The  two-inch  incision  is  made  with  a  sharp 
scalpel  through  the  skin  and  subcutaneous  tissue.  A 
stab  is  then  made  with  a  long  abcess  knife  from  the 
mouth  of  this  incision,  obliquely  upwards  and  in- 
wards, until  it  reaches  the  normal  apex  of  the  withers.) 
This  stab-wound  is  then  widened  laterally  with  a  long, 
straight  probe-pointed  bistoury.  This  drainage  must 
always  be  made  on  both  sides,  even  if  the  condition 
is  apparently,  confined  to  one  side  only. 

When  these  openings  have  been  made  as  directed 
the  first  treatment  is  given  at  once  consisting  of  thor- 
ough irrigation  with  a  ten  per  cen  solution  of 
chromium  trioxide.  This  is  done  most  satisfactorily 
with  a  fountain  syringe,  using  a  long  nozzle,  which 
can  be  inserted  in  the  wound  far  enough  to  reach 
nearly  to  the  top  of  the  withers. 

Chromium  trioxide  is  the  remedy  of  choice  here. 
It  stops  sloughing  and  odor  almost  immediately  and 
its  action  is  painless. 

When  the  first  treatment  has  been  given,  both 
openings  should  be  snugly  packed  their  full  length 
with  gauze,  which  is  allowed  to  remain  for  eight  or 
ten  hours.  It  is  then  removed  and  the  wounds  are 
allowed  to  remain  open.     Subsequent  treatment  con- 


16  SPECIAL  VETERINARY  THERAPY 

sists  in  irrigating  the  tracts  once  each  day  with  a 
three  or  four  per  cent  solution  of  chromium  trioxide, 
following  this  irrigation  every  time  with  one  of  plain, 
sterile  water.  After  ten  days  or  two  weeks  these 
irrigations  are  made  only  every  other  day,  and  at 
proper  intervals  an  iodine  solution  is  used  in  their 
place. 

Unless  the  case  is  an  exceptionally  severe  one,  all 
traces  of  pus  and  necrotic  tissue  will  have  disap- 
peared at  the  end  of  four  weeks  and  only  one  or  two 
per  cent  solutions  of  the  chromium  salt  are  then  used, 
and  at  intervals  of  three  days.  About  this  time,  the 
external  surface  of  the  withers  also  is  to  be  painted 
every  two  or  three  days  with  tincture  iodine  U.  S.  P. 
It  is  only  very  rarely  that  a  case  resists  this  treat- 
ment and  as  a  rule  complete  recovery  comes  in  five  or 
six  weeks.  If  autogenous  bacterins  are  used  at  the 
same  time  this  can  be  shortened  considerably. 

With  this  treatment,  the  surgeon  can  hasten  mat- 
ters considerably  during  the  first  week  or  two  by 
careful  and  gentle  curettage  in  the  necrotic  area,  re- 
moving gently  any  portions  of  tissue  which  are  loose 
or  tending  to  become  separated.  If  the  primary  in- 
cision is  made  full  two  inches  wide,  a  good  opening 
remains  until  treatment  is  terminated. 


Wire-Cuts— Lacerated  Injuries. 

Wire-cuts  and  similar  injuries  are  serious  only 
when  important  structures  such  as  the  articulation, 
tendons  or  other  parts  equally  vital  are  involved. 
Lacerations  of  the  fleshy  parts  can  be  of  very  great 
extent  without  producing  serious  results.  Dangerous 
infections  in  such  wounds  are  exceedingly  rare  be- 
cause the  wound  is  usually  open  and  gaping. 

In  cattle  such  injuries  are  always  to  be  sutured. 
Healing  is  prompt  and  stitches  hold.  In  the  horse, 
with  few  exceptions,  suturing  is  a  waste  of  time  and 
the  open  treatment  is  best.  When  tendons  are 
severed,  it  is  of  importance  to  consider  the  patient's 
disposition  before  attempting  to  re-unite  the  ends  by 
suture.  A  colt  with  an  intractable  disposition  will 
not  submit  to  applications  for  immobilizing  a  limb, 
especially  a  hind  limb,  and  without  immobilization, 
suture  of  a  tendon  is  useless.  In  the  end,  and  on  the 
average,  just  as  good  results  come  from  the  open  treat- 
ment even  in  such  cases. 

With  the  following  treatment  ninety-nine  per  cent 
of  wire-cuts  encountered  in  usual  practice  will  heal 
promptly  with  but  little  scar  formation. 

Kalii  Permanganatis   C.   P 3  iv 

Aquae   Destillatae - 5  viij 

M.  Sig. — Apply  two  or  three  times  daily 
with  a  small  brush,  painting  over  the 
wound  repeatedly  each  time  until  the 
tissue  assumes  a  blackish  color. 

%1 


18  SPECIAL  VETERINARY  THERAPY 

If  properly  applied  no  excessive  granulations 
(proud  flesh)  ever  appears.  This  should  be  kept  right 
up  until  the  wound  is  entirely  healed.  It  is  surprising 
how  little  scar  will  remain  from  a  very  severe  cut 
when  this  treatment  is  used.  By  keeping  the  wound 
surface  seared  with  this  caustic  solution,  no  flies  will 
bother  and  no  further  treatment  is  required.  As  the 
potassium  permanganate  will  not  dissolve  entirely  in 
the  proportions  given  above,  a  ''shake"  label  should 
be  put  on  the  bottle. 


Open  Joints. 


These  will  be  considered  in  two  parts,  namely, 
those  of  recent  origin  in  fresh  wounds  and  those  of 
a  chronic  or  subacute  and  infected  character. 

1.  Fresh  Wounds,  Lacerating  a  Capsular  Liga- 
ment. It  frequently  happens,  as  the  result  of  acci- 
dents, that  an  articulation  is  involved  in  the  trauma. 
While  all  accidental  wounds  in  veterinary  patients  are 
to  be  considered  surgically  unclean,  it  is  well  not  to 
carry  this  theory  too  far.  Unless  much  extraneous 
matter  such  as  hair,  chaff,  etc.,  has  entered  directly 
into  the  articulation,  do  not  allow  antiseptic  solutions 
to  penetrate  to  the  synovial  surfaces  when  cleaning 
up  such  a  wound. 

Swab  the  surrounding  parts  as  clean  as  possible 
with  cotton,  but  do  not  allow  any  of  the  solution  to 
reach  the  joint.  (Nothing  seems  to  irritate  a  synovial 
cavity  more  than  water.)  After  the  surrounding  parts 
are  thoroughly  swabbed  and  dried  with  clean,  dry 
cotton,  the  wound  cavity  is  completely  filled  with 
powdered  natrium  bicarbonate,  C.  P.,  some  of  which 
is  even  gently  pressed  so  as  to  enter  the  synovial 
cavity.  It  is  important  that  enough  be  used.  A  thin 
layer  of  cotton  is  now  made  to  cover  the  lesion  and 
retained  either  with  collodion  or  bandages. 

This  dressing  should  be  allowed  to  remain  for 
twenty-four  hours.     At  the  end  of  that  time  it  should 

19 


20  SPECIAL  VETERINARY  THERAPY 

be  removed  and  the  wound  carefully  inspected  for 
synovia.  No  instrumentation  is  permissable;  the  in- 
spection is  confined  to  looking  into  the  wound  for 
traces  of  synovia.  If  no  synovia  is  to  be  seen  the 
wound  is  treated  along  regular  lines ;  ordinarily  as  de- 
scribed for  wire-cuts. 

If  synovia  is  present  in  the  wound,  the  treatment 
is  repeated  as  on  the  first  occasion  and  again  left  on 
for  twenty-four  hours.  More  than  two  such  applica- 
ions  are  seldom  necessary  and  unless  the  wound  has 
been  very  large  and  is  very  severely  infected,  good 
healthy  granulations  and  no  synovia  are  present  after 
the  first  twenty-four  or  forty-eight  hours. 

2.  Chronic,  Infected,  Purulent  Joints.  The 
treatment  of  these  is  radical.  While  it  happens  now 
and  then  that  cases  of  this  kind  recover  with  dilatory 
methods  of  treatment,  it  is  only  by  radical  procedure 
that  prompt  and  positive  results  can  be  obtained. 

The  various  articulations  of  the  equine  present 
varying  degrees  of  severity  and  obstinacy  in  this  afifec- 
tion.  The  elbow  joint  stands  at  the  head  of  the  list  of 
fatal  terminations.  I  would  class  the  coffin  joint  sec- 
ond; next  in  order  I  would  place  the  hock;  last,  the 
stifle. 

The  following  method  of  treatment  is  always  suc- 
cessful in  cases  in  which  the  patient  has  not  become 
greatly  emaciated  and  still  retains  the  greater  part  of 
his  vitality  and  good  spirits.  It  is  successful  in  fifty 
per  cent  of  the  latter  cases  but  it  is  of  no  avail  (nor 
any  other  treatment)  in  cases  where  the  patient  is 
down  and  refuses  to  eat.     Such  cases  rally  occasionally 


OPEN  JOINTS  21 

for  a  temporary  period,  only  to  go  down  again  later 
and  die.  If  the  surgeon  will  select  for  this  treatment 
cases  that  are,  while  moderately  grave,  still  in  good 
general  condition,  or  even  fair,  he  can  promise  his 
client  good  results. 

To  carry  out  this  treatment  properly,  it  is  essen- 
tial to  cast  the  patient,  either  on  the  ground  or  on  the 
table.     The  following  procedure  is  then  adopted: 

Thoroughly  cleanse  the  region  of  the  joint  in- 
volved, shave  and  scrub.  Irrigate  the  joint  cavity 
for  at  least  ten  minutes  with  a  solution  of  hydrargyri 
chloridum  corrosivum  1  to  3000  at  body  temperature. 
This  must  be  done  with  the  utmost  antiseptic  pre- 
cautions and  great  delicacy.  If  the  opening  in  the 
joint  is  in  such  a  position  that  good  drainage  can  not 
be  obtained,  another  opening  is  to  be  made  surgically 
at  the  desired  point. 

Having  thoroughly  flushed  the  joint  cavity  with 
the  solution,  for  which  purpose  a  fountain  syringe  is 
best,  it  is  again  flushed  for  a  considerable  time  with 
plain  sterile  physiological  saline  solution  at  body  tem- 
perature. These  washings  are  only  to  be  discontinued 
when  the  fluid  comes  out  clear  and  free  from  pus 
flakes  or  detritus.  It  may  take  a  half  hour  of  con- 
tinuous irrigation  to  accomplish  this :  When  this 
has  been  accomplished  the  interior  of  the  joint  may 
be  considered  surgically  clean  and  it  is  now  immedi- 
ately injected  with  the  following  suspension: 

Hydrargyri  lodi  rub 3  Iv 

Ol.   Olivae  Purae  5  vj 

M.  Sig. — Shake  before  using. 


22  SPECIAL  VETERINARY  THERAPY 

This  should  be  injected  into  the  cavity  slowly  after 
plugging  up  all  openings,  except  the  one  through 
which  it  is  to  be  injected  and  be  sure  every  portion 
of  the  interior  comes  in  contact  with  the  suspension. 

As  soon  as  this  is  done  the  entire  joint  is  swathed 
in  clean  cotton  held  in  place  by  such  bandages  or  re- 
taining appliances  as  the  surgeon's  ingenuity  may  de- 
vise. This  dressing  should  remain  in  place  for  tAvo 
weeks. 

In  nine  out  of  ten  cases  a  complete  cure  will  have 
been  effected  when  the  dressing  is  removed  at  the  end 
of  this  time.  In  rare  cases  it  may  be  necessary  to  re- 
peat the  treatment. 

It  is  very  imporant  that  the  entire  joint  be  heavily 
swathed  in  cotton  which  must  be  held  snugly,  yet 
not  tightly  in  place. 

The  patient  must  be  kept  as  quiet  as  possible  until 
the  two  weeks  have  elapsed,  and  during  this  time 
should  receive  a  dram  of  hexamethylenamine  in  a  pail 
of  drinking  water  three  times  daily. 

Hexamethylenamine  is  of  much  value  in  various 
forms  of  arthritis.  It  has  been  found  that  it  is  ex- 
creted by  serous  membranes  and  it  has  been  demon- 
strated to  be  present  in  synovial  cavities  within  an 
hour  or  two  after  administration.  Its  antiseptic  action 
is  due  to  formaldehyde  which  is  liberated  during  the 
process  of  elimination. 


Chronic  Laminitis. 

Cases  of  chronic  laminitis  as  a  rule  come  to  the 
practitioner  "second-hand,"  that  is,  after  some  other 
practitioner  has  been  unsuccessful  in  satisfactorily 
terminating  an  acute  laminitis. 

Usually,  in  these  cases,  anatomical  changes  have 
occurred  in  the  foot  that,  in  themselves,  are  beyond 
repair.  These  changes  vary  from  the  ordinary 
dropped  sole  to  perforation  of  the  sole  by  the  os  pedis 
with  concomitant  conditions,  the  result  of  infection 
and  bruising.  At  best  the  latter  cases  are  in  a  pitiable 
state,  and  it  is  doubtful  what  sort  of  prognosis  should 
be  given. 

The  most  common  cases  of  chronic  laminitis 
which  come  to  the  practitioner,  present  considerable 
lameness  and  the  ordinary  dropped  sole.  For  these 
cases,  we  have  in  potassium  iodide  almost  a  specific. 
It  should  be  given  in  one  dram  doses  in  solution,  one 
dram  three  times  daily,  for  an  indefinite  period. 

At  the  same  time  the  mixture  given  below  is  to 
be  applied  in  the  coronary  region  once  each  day  with 
a  stiff  brush,  keeping  the  applications  up  for  two  or 
three  weeks. 

Tr.  Cantharides. 

Ol.  Cajuput. 

Ol.  Terebinth aa  5  i 

Tr,  Iodine 5  iij 

M. 

23 


24  SPECIAL  VETERINARY  THERAPY 

Attention  must  be  given  to  shoeing  and  a  rest  of 
several  weeks  in  a  well-bedded  box-stall  is  helpful. 
If  the  sole  is  "dropped"  to  a  considerable  extent, 
heavy  leather  should  always  be  applied  between  the 
shoe  and  foot;  or  better  still,  a  protection  band  of  iron 
should  run  across  the  bottom  of  the  foot  between  the 
sides  of  the  shoe.  This  band  must  not  quite  touch 
the  sole. 


Hyperesthesia  of  the  Neck. 

This  condition,  sometimes  termed  "crazy"  sore 
neck,  is  well-known  among  veterinarians  and  affects 
only  work-horses.  It  appears  in  two  forms;  one  in 
which  the  neck  appears  to  be  only  slightly  sore  at  the 
collar  seat;  the  other,  in  which  there  is  a  plug  or 
wedge  of  necrotic,  dry  tissue  in  the  centre  of  the 
region. 

The  first  form  is  the  most  difficult  to  terminate. 
The  horse,  when  an  attempt  is  made  to  put  on  the 
collar  or  take  it  off,  becomes  literally  crazy;  he  at- 
tempts to  kick,  strike,  rear  up  or  bite;  in  many  cases 
becoming  w^ell  nigh  unmanageable.  While  these 
cases  usually  begin  with  an  ordinary  *'sore  neck,"  the 
animal  seems  to  retain  his  **crazy"  disposition  even 
after  the  parts  have  been  healed  up  and  no  trace  of 
"sore  neck"  is  evident. 

The  second  form,  in  which  there  is  present  a  plug 
or  wedge  of  dead  tissue,  is  easily  brought  to  a  favor- 
able termination.  Surgical  removal  of  the  dead  mass, 
(which  usually  has  the  appearance  of  horn  and  may 
be  several  inches  in  length  and  imbedded  deeply)  and 
then  treatment  of  the  wound  puts  an  end  to  the 
trouble. 

In  the  first  form,  however,  there  seems  to  exist  a 
genuine  hyperesthesia  of  the  neck  region  and  a  severe 
underlying  dermatitis   is  always  present.     The   only 

25 


26  SPECIAL  VETERINARY  THERAPY 

evidence  thereof  is  a  slight  fullness  or  thickening,  with 
local  heat.  Occasionally  cases  of  this  form  occur 
which  are  only  cured  after  the  animal  has  been  given 
a  protracted  rest  from  service  in  the  collar.  It  is  pos- 
sible, sometimes,  to  accomplish  much  by  substituting 
a  breast  collar. 

Cases  in  which  the  horse  shows  no  especial  vicious 
disposition,  usually  terminate  favorably  with  a  few 
weeks'  treatment  with  Prof.  A.  H.  Baker's  "toughen- 
ing lotion."  This  is  applied  two  or  three  times  daily 
with  the  hand,  thoroughly  painting  the  entire  collar 
seat  with  it.  It  is  made  by  dissolving  two  ounces  of 
tannic  acid  in  six  ounces  of  dilute  acetic  acid  and 
two  ounces  of  powdered  alum  in  six  ounces  of  water. 
Mix  them  and  it  is  ready  for  use. 

A  zinc-lined  pad  should  be  used  for  these  cases. 

In  the  more  desperate  type  of  these  cases,  in  which 
the  foregoing  treatment  has  not  accomplished  any- 
thing, an  entirely  different  procedure  is  necessary. 
The  deep,  underlying  dermatitis  in  such  cases  is  not 
benefited  by  topical  applications.  From  various 
salves,  lotions  and  other  treatments  which  have  been 
applied,  the  epidermis  has  assumed  a  tough,  pachy- 
dermal  character  and  local  treatment  is  useless.  Such 
cases  are  cast,  either  on  the  ground  or  table,  and  the 
epidermis  is  shaved  off  the  entire  region  with  a  sharp 
sage  knife.  Oozing  of  blood  must  be  the  guide  for 
the  depth  of  the  shaving.  It  is  well  to  have  several 
sharp  knives  at  hand. 

When  shaving  process  has  been  thoroughly  gone 
through,  having  paid  special  attention  to  the  bottom 


HYPERESTHESIA  OF  THE  NECK  27 

of  the  folds  in  the  skin,  the  entire  region  is  swabbed 
with  mild  bichloride  solution  until  all  bleeding  has 
stopped.  This  is  important;  all  bleeding  must  be 
stopped  before  the  next  step  is  undertaken. 

Having  previously  made  a  saturated  solution  of 
iodoform  in  ether,  which  should  be  contained  in  an 
atomizer,  the  whole  bare  area  is  freely  sprayed  there- 
with ;  it  dries  at  once  and  leaves  a  solid  coating  of 
iodoform. 

This  is  allowed  to  remain  for  twenty-four  hours, 
after  which  it  is  washed  off  with  ether  and  the  neck  is 
then  treated  daily  with  the  toughening  lotion  as  given 
above  for  ordinary  cases. 

This  method  is  nearly  always  successful.  In 
horses  that  are  naturally  mean  or  vicious,  a  variable 
period  may  elapse  even  after  this  treatment  before 
they  are  again  entirely  docile  in  this  respect. 

In  occasional  cases  good  results  follow  the  internal 
administration  of  Fowler's  solution  in  small  doses  for  a 
prolonged  period.  A  zinc  pad  does  much  good  in  all 
cases.  The  use  of  deer-skin  and  other  hairy  or  wooley 
pads  should  be  discouraged  on  general  principles 
because  they  are  insanitary  and  almost  impossible  to 
keep  clean. 


Chronic  Eczema,  Scratches,  Grease 
Heel 


It  is  not  necessary  to  dwell  on  the  symptoms  of 
these  conditions.  While  very  common  and  readily 
recognized  their  obstinacy  to  treatment  is  equally 
well  known. 

In  all  cases  thorough  washing  with  soap  and  warm 
water  should  begin  the  treatment,  but  after  this  no 
further  washing  should  be  done.  A  very  important 
point  in  the  subsequent  handling  of  the  case  lies  in 
keeping  the  parts  dry. 

Having  thoroughly  cleansed  the  parts,  the  follow- 
ing mixture  is  applied  with  a  small  brush  morning 
and  evening  until  healing  has  begun.  Usually  a  week 
or  ten  days  suffices  for  the  first  course  and  twelve 
ounces  of  the  mixture  is  about  the  quantity  required. 

Hydrargyri     Chloridimite 3  i^ 

Ol.  Cajuputi  5  ij_ 

Ol.  Gossypii    Semen q.   s.  5  xij 

M. — Shake  the  first  two  ingredients  to- 
gether vigorously  before  adding  the 
third.    Apply  as  directed  above. 

When  this  has  been  used  the  parts  have  a  healthy 
tone  and  the  cracks  and  ulcers  show  nice,  healthy  tis- 
sue. 

^9 


30  SPECIAL  VETERINARY  THERAPY 

The  treatment  is  carried  to  termination  with  the 
following : 

Tr.  Benzoin  Compound. 

Tr.  Iodine aa  5  iij 

M.     Sig. — Apply     with     a     small     brush 
morning  and  evening. 

In  most  cases  this  completes  the  treatment  and 
leaves  a  smooth,  velvety  area  of  skin.  In  occasional 
cases  the  skin  has  not  become  quite  smooth  when  the 
last  mixture  has  been  used  up  and  in  these  the  treat- 
ment is  completed  with  the  following: 

Acid  Tannic S  i 

Glycerin    5  ij 

Aqua  q,  s.  ad 5  viij 

M. — This   is    also   applied   v/ith   a    small 
brush  once  or  twice  daily. 

In  well  developed  cases  of    grease    heel    put    the 

patient  on  a  course  of  potassium  iodide.     If  this  is  not 

practicable     use     strepto-bacterin.       Some     cases    of 

"scratches"  are  attributed  by  some  authors  to  variola. 

It  is  doubtful  whether  this  is   correct.     The  matter 

requires  further  investigation. 


V 


it 


Cracked"  Heels  in  Track  Horses. 


This  is  a  condition  peculiar  to  speed  horses  and  is 
an  aggravated  form  of  eczema,  presenting  deep  cracks 
or  furrows  in  the  hollow  of  the  heel.  It  is  apparently 
the  result  of  the  all  too  frequent  leg  washing  to  which 
these  horses  are  subjected.  The  various  solutions  and 
water  collect  in  the  cup  of  the  heels  that  are  after- 
wards improperly  dried. 

Therefore  the  first  requisite  to  a  successful  termina- 
tion of  treatment,  is  the  discontinuance  of  such  wash- 
ing or  at  least  that  the  leg  wash  be  given  in  such  a 
manner  that  the  fluid  will  not  come  in  contact  with 
the  cracks.  Most  of  these  cases  are  chronic,  and  of 
long  standing  when  they  come  into  the  veterinarian's 
hands.  This  is  an  important  point  to  consider  in  their 
treatment.  The  edges  of  the  cracks  are  hard,  indur- 
ated and  have  almost  a  fibrous  appearance. 

Treatment  should  commence  with  careful  curette- 
ment  of  the  edges  and  sides  of  the  cracks.  While 
carefully  and  cleanly  done,  this  curetting  must  be  done 
thoroughly,  scraping  off  all  hardened  tissue  and  pro- 
ducing in  effect  a  fresh  wound. 

When  this  has  been  done,  the  parts  should  be  cov- 
ered with  a  mercury  bichloride  solution  1  to  2000, 
packed  and  bandaged.  This  dressing  is  allowed  to  re- 
main in  place  for  eight  or  ten  hours.  It  is  then  re- 
moved and  the  cracks  thoroughly  swabbed  out  with 

SI 


32  SPECIAL  VETERINARY  THERAPY 

dry  cotton.  Then  the  following  mixture  should  be  ap- 
plied three  times  daily  until  healing  is  complete,  which 
takes  two  or  three  weeks  as  a  rule. 

Balsam   Peru 3  ij 

Tr.  Benzoin  Compound 3  ij 

This  amount  is  used  for  each  foot  at  each  applica- 
tion and  is  heated  slightly  over  a  match.  It  is  then 
poured,  warm,  into  the  cracks.  If  granulations  are 
slow  or  lack  vitality,  a  light  cauterization  with  silver 
nitrate  or  stimulation  with  pure  tincture  of  iodine  once 
or  twice  will  hasten  them.  In  exceptionally  stubborn 
cases,  a  red  iodide  of  mercury  and  cantharides  blister 
should  precede  all  other  treatment. 


Prolonged  Analgesia  in  Ophthalmia. 

In  most  of  the  ailments  of  the  eye  of  the  horse, 
that  are  serious  enough  to  require  treatment,  the  great 
amount  of  pain  and  photophobia  present  are  obstacles 
to  the  examination  and  manipulation  required.  The 
animal  forcibly  resents  any  attempts  to  examine  the 
injured  optic  and  even  the  application  of  the  twitch 
does  not  help  matters  much. 

It  is  not  practical  and  rather  costly,  to  instill  a 
cocaine  solution  and  too  often  a  careless  examination 
is  made  and  an  eye  lotion  prescribed. 

By  following  the  plan  which  I  shall  outline  it  is 
possible  to  relieve  the  excessive  pain  in  a  few  min- 
utes, after  which  the  animal  will  usually  open  the  eye 
fully  so  that  a  careful  inspection  may  be  made,  and  if 
further  examination,  with  a  speculum,  is  necessary, 
the  animal  resists  but  little  or  not  at  all. 

The  procedure  consists  of  first  removing  all  traces 
of  mucous  or  other  discharge  with  a  cotton  swab  and 
sterile  water.  When  this  has  been  done,  a  one-grain 
hypodermic  tablet  of  quinine-urea  hydrochloride  is 
placed  into  the  conjunctival  sac  at  the  inner  canthus. 
It  dissolves  quickly,  promoting  a  flow  of  lachrymal 
fluid  and  apparently  produces  an  anesthesia  of  the  en- 
tire organ  and  membranes.  Within  ten  or  fifteen 
minutes  the  animal  will  open  the  eye  freely  and  ap- 

39 


34  SPECIAL  VETERINARY  THERAPY 

parently  is  free  from  pain.  This  analgesic  effect  lasts 
for  several  days. 

In  addition  the  quinine-urea  hydrochloride  seems 
to  exert  an  antiseptic  and  astringent  power  which  will 
quickly  terminate  ordinary  inflammations  of  the  eye. 
In  corneal  ulcer  this  effect  is  especially  striking. 

To  obtain  the  best  results  it  is  of  great  importance 
to  use  only  sterile  water  in  cleaning  the  eye  before 
inserting  the  tablet.  No  antiseptic  solutions  should 
be  used. 


Specific  for  Infectious  Entero- 
Hepatitis  in  Fowls. 

There  is  no  doubt  in  my  mind  that  we  have  in 
potassium  dichromate  a  specific  for  this  disease  in 
every  sense  of  the  v^ord.  It  is  not  only  curative ;  it  is 
also  prophylactic. 

In  a  number  of  flocks  in  v^hich  this  treatment  was 
used  in  three  different  epiornithics,  the  results  were 
so  satisfactory  in  every  respect  that  it  deserves  notice. 
In  all  cases  the  outbreak  terminated  promptly;  sick 
hens  recovered  and  hardly  ever  a  new  case  developed 
after  the  treatment  was  begun. 

The  potassium  dichromate  should  be  given  in  the 
drinking  water,  dissolving  it  in  the  water  in  the  pro- 
portion of  about  six  grains  to  the  quart.  A  fresh 
solution  should  be  made  twice  a  day  and  the  hens  con- 
fined for  five  or  six  days  so  that  they  will  not  have 
access  to  any  other  water  during  this  time.  With 
this  strength  of  solution,  the  hens  will  get  from  one- 
eighth  to  three-eighths  grains  during  the  day's  drink- 
ing estimating  from  one  to  one  and  one-half  ounces 
of  the  solution  per  hen,  which  is  high. 

Sick  birds  which  will  not  drink  should  be  given  a 
teaspoonful  of  the  solution  every  three  hours  during 
the  day. 


36  SPECIAL  VETERINARY  THERAPY 

Although  this  disease  is  supposed  to  affect  turkeys 
chiefly,  it  is  far  more  common  among  chickens  than 
is  generally  presumed.  It  can  easily  be  demonstrated 
by  post-mortem  examination. 

Whenever  the  disease  has  gone  through  a  flock 
the  hen  house  and  all  accessories  should  be  thoroughly 
renovated.  If  this  is  not  done,  isolated  cases  in  an 
atypical  form  may  make  their  appearance  indefinitely. 

In  this  as  in  all  contagious  or  infectious  diseases, 
isolation  of  the  sick  helps  to  curtail  the  outbreak  con- 
siderably. As  soon  as  a  bird  shows  signs  of  the  di- 
sease it  should  be  taken  out  of  the  flock. 


Occlusion  of  the  Lachrymal  Ducts. 

As  a  pathologic  entity,  this  condition  is  easy  to 
diagnose.  Partial  and  complete  occlusion  occurs 
sometimes  with  severe  conjunctivitis  and  other  severe 
inflammations  of  the  eye  and  appendages.  In  such 
cases  the  duct  nearly  always  resumes  its  function  and 
becomes  pervious  again  with  the  recovery  of  the 
patient  from  the  exciting  cause,  whether  it  be  a  con- 
junctivitis or  some  other  disease. 

When,  however,  we  have  occlusion  of  one  or  both 
lachrymal  ducts  as  a  primary  condition,  we  see  a 
clinical  picture  which  is  characteristic. 

The  eye  itself  and  the  conjunctiva  appear  normal; 
nothing  abnormal  can  be  seen  even  by  careful  exami- 
nation. The  eye  is  only  partially  open  and  a  constant 
stream  of  lachrymal  fluid  is  making  its  escape  from 
the  edges  of  the  lids.  The  nasal  opening  of  the  duct 
is  dry.  When  the  horse  is  brought  into  bright  light, 
constant  blinking  is  gone  through,  very  much  like 
a  person  just  awakened. 

With  few  exceptions,  these  cases  are  due  to  a 
thickening  of  the  membrane  lining  the  duct  as  a  result 
of  catarrhal  inflammation.  The  usual  procedure  of 
catheterizing  and  then  irrigating  the  duct,  the  teaching 
of  our  text-books  for  this  conditoin,  is  far  from  satis- 
factory and  very  impracticable.     In  fact,  in  general 

J7 


38  SPECIAL  VETERINARY  THERAPY 

practice  it  can  hardly  be  carried  out  without  inflicting 
additional  injury  to  the  delicate  parts  involved. 

The  treatment  described  below  has  been  used  suc- 
cessfully since  1908  and  if  carefully  and  persistently 
carried  out  a  cure  can  nearly  always  be  obtained 
within  a  reasonable  time,   usually  four  weeks. 

One  of  the  important  steps  in  beginning  this  treat- 
ment is  to  give  explicit  instructions  to  the  person  in 
whose  care  the  animal  is  while  imder  treatment,  as 
regards  the  great  delicacy  and  absolute  cleanliness 
with  which  the  eye  must  be  handled.  Too  much 
stress  can  not  be  put  on  this  point.  The  average 
horseman  uses  very  poor  judgment  in  this  respect. 

The  treatment  begins  with  a  very  gentle  removal 
of  clots  of  mucus  from  the  inner  canthus.  Some  of 
this  is  always  present  and  a  clean  piece  of  absorbent 
cotton  is  to  be  used  for  this  purpose.  Following  this, 
a  lump  of  two  per  cent  yellow  oxide  of  mercury  oint- 
ment of  about  the  size  of  a  grain  of  corn,  is  gently 
placed  in  the  eye  at  the  inner  canthus  and  the  lids 
gently  pressed  together  with  the  fingers. 

This  is  done  once  each  day  until  recovery  occurs, 
and  every  second  or  third  day  an  innunction  is  made 
on  the  course  of  the  facial  portion  of  the  duct,  (that 
is,  from  just  below  the  eye  to  within  a  few  inches  of 
the  nose)  with  half  strength  mercurial  ointment.  This 
should  be  gently  massaged  in  over  the  approximate 
course  of  the  duct. 

If  it  is  desired  to  hasten  recovery,  a  course  of  iodide 
of  potassium  will  be  helpful. 


Choke  in  the  Horse. 

If  there  is  a  condition  in  veterinary  practice  in 
which  the  veterinarian  must  demonstrate  tact  and 
absolute  control  of  the  client  (not  the  patient)  this  is 
certainly  the  one. 

In  all  these  cases  the  owner  or  attendant  is  to  be 
taken  in  hand  firmly.  Often  times  this  requires  as 
much  judgment  on  the  part  of  the  attending  surgeon 
as  the  treatment  of  the  case  in  hand.  Usually  they 
have  heard  of,  or  seen  used,  probangs,  (buggy-whips, 
broom  handles,  traces,  and  what-not  in  the  form  of 
probangs)  and  they  want  an  immediate  demonstration 
of  similar  tactics.  They  want  to  rub  and  massage  the 
neck,  pour  into  the  animal  quantities  of  oil,  and  to  do 
a  thousand  and  one  other  things. 

Ninety-five  per  cent  of  all  chokes  are  really  very 
benign  conditions  when  treated  early.  In  many  cases 
it  is  the  treatment  administered  that  transforms  the 
case  into  a  really  grave  one.  I  do  not  fear  contra- 
diction when  I  say  that  nearly  all  chokes  would  be 
relieved  spontaneously  if  the  horse  were  at  once  placed 
where  he  could  get  nothing  whatever  to  eat  but  plenty 
of  water  to  suck  up.  In  esophageal  choke  the  water 
taken  is  usually  ''sucked"  tentatively. 

The  pathology  of  nearly  all  chokes  is  confined  to 
esophageal  spasm.  In  exceptional  cases  a  jabot  or 
more  or  less  permanent  dilatation  may  exist  previously 
and  remain  permanently. 

39 


40  SPECIAL  VETBRIN'ARY  THERAPY 

Most  of  the  chokes  we  meet  in  general  practice 
are  sporadic  cases,  and  never  recur ;  therefore  the  habit 
of  attributing  all  cases  of  choke  to  previously  and 
permanently  existing  dilatations  not  only  is  not  borne 
out  by  practical  evidence,  but  is  misleading.  If  this 
fallacy  be  firmly  grounded  in  the  surgeon's  mind,  his 
treatment  will  be  in  gross  error.  Just  as  soon  as  the 
veterinarian  treats  his  cases  of  choke  with  the  under- 
standing that  they  are  almost  without  exception  due 
to  a  spasm  only,  a  tonic  spasm  of  the  esophagus,  he 
begins  to  have  prompt  and  very  satisfactory  results. 
As  long  as  he  is  possessed  of  the  jabot  or  dilatation 
theory  as  a  factor  in  choke  he  has  trouble  with  them, 
because  he  undertakes  to  do  too  much, 

When  called  to  a  case  of  choke  in  the  horse,  the 
veterinarian  must  keep  himself  well  in  hand  and  must 
not  allow  himself  to  become  biased  by  the  owner's  or 
the  attendant's  perspective.  Make  up  your  mind 
firmly  that  you  are  handling  a  very  simple  functional 
disturbance  and  proceed  to  place  your  client  in  the 
same  frame  of  mind.  When  you  succeed  in  doing 
this  you  have  your  case  fifty  per  cent  cured. 

If  a  box  stall  is  available,  have  the  horse  put  there ; 
if  none  is  available,  allow  him  to  remain  in  the  single 
stall.  But  in  either  case,  see  to  it  that  the  floor,  man- 
ger and  feed  box  is  absolutely  freed  from  feed  of  any 
kind ;  use  a  broom  and  sweep  them  clean.  When  this 
has  been  done,  a  large  pail  or  a  tub  of  water  should 
be  placed  where  the  horse  can  reach  it  without  any 
special  effort  on  his  part.  When  this  has  been  done 
the  veterinarian  should  administer  from  one  to  two 


CHOKE  IN  THE  HORSE  41 

grains  of  pilocarpine  hydrochloride,  hypodermatically. 
As  soon  as  salivation  starts  from  this  injection,  usually 
in  five  to  ten  minutes,  the  veterinarian  and  all  others 
can  serve  the  patient  best  by  going  away  and  leaving 
him  alone.  In  a  good  deal  more  than  half  of  all  cases 
of  choke,  all  evidence  of  its  existence  has  passed  off  at 
the  end  of  three  hours  following  this  line  of  treat- 
ment. 

When  the  surgeon  again  visits  the  patient  (three 
or  four  hours  after  giving  the  pilocarpine  is  a  good 
time  to  call  again  in  these  cases)  he  should  attempt 
to  make  the  animal  go  through  several  acts  of  degluti- 
tion. If  the  horse  on  these  attempts  swallows  with- 
out arousing  the  characteristic  gurgling  and  spasm 
of  the  muscles  in  the  cervical  region  he  may  con- 
sider the  case  cured.  However,  nothing  but  water  and 
a  very  thin  bran-slop  should  be  allowed  for  at  least 
twelve  hours  more. 

In  the  event  that  the  choke  is  not  relieved  by  the 
treatment  thus  given,  it  is  not  yet  time  to  get  excited 
by  any  means,  especially  if  the  choke  is  in  the  cer- 
vical region  where  it  may  be  relieved  by  an  operation 
if  everything  else  fails.  Here  I  desire  to  say  that  I 
have  yet  to  see  a  case  of  equine  choke  due  to  spasm 
of  the  esophagus,  which  resisted  patient  and  simple 
means  of  treatment,  such  as  given  above.  Occa- 
sionally one  of  these  cases  will  "hang  on"  for  twenty- 
four  or  forty-eight  hours,  when  suddenly  the  animal 
swallows  normally  and  is  well. 

In  the  event  that  recovery  has  not  taken  place 
after  three  or  four  hours  from  this  treatment,  I  have 


42  SPECIAL  VETERINARY  THERAPY 

used  successfully,  for  a  number  of  years,  an  injection 
of  one  grain  apomorphine,  hypodermatically.  The 
horse  is  still  retained  in  a  clean  stall  free  from  feed, 
and  water  is  kept  constantly  before  him.  After  the 
injection  of  the  apomorphine,  five  or  six  hours  are 
allowed  to  elapse  before  anything  further  is  attempted. 
Should  the  choke  still  be  in  evidence  at  the  end  of 
this  time  (a  very  rare  occurence)  the  surgeon  can  be- 
gin to  think  of  operating.  Talk  to  your  client  and 
prepare  him  for  what  you  may  have  to  do,  but  do  not 
do  it  yet.  Allow  another  five  or  six  or  even  ten  or 
twelve  hours  to  pass  with  the  horse  kept  in  a  clean 
stall  as  before.  The  chances  are  that  you  will  be 
very  pleased  over  your  good  judgment  at  the  end  of 
of  this  time ;  your  client  will  be  even  more  so. 

If  you  should  be  so  unfortunate  as  to  meet  with  a 
case  of  real  jabot,  (that  is  what  you  undoubtedly 
have  when  the  foregoing  procedure  fails)  your  patient 
is  just  as  good  a  subject  for  the  necessary  operation, 
if  you  have  not  allowed  him  to  swallow  any  food 
since  he  became  choked,  as  he  was  when  you  first  saw 
him.  You  have  used  good,  sound  and  expert  judge- 
ment and  have  not  harmed  your  client  nor  his  horse. 
You  have  given  them  both  every  possible  chance. 

Then  operate  according  to  the  directions  given  by 
Merrillat. 

Here  I  can  promise  the  surgeon  that  his  operations 
for  choke  in  horses  will  be  few  and  far  between  if  he 
follows  patiently  the  instructions  outlined  above. 


Hemorrhage  from  the  Palatine 
Artery. 

Hemorrhage  from  the  palatine  artery  is  always 
serious,  requiring  prompt  and  efficient  measures  for  its 
control.  How  disagreeable  a  task  it  is,  to  treat  such 
an  occurrence  can  be  learned  only  from  experience. 
However,  one  case  is  usually  enough  to  demonstrate 
this  part  of  the  matter. 

The  veterinarian  who  has  had  the  good  fortune, 
(or  possibly  misfortune  would  be  the  better  term)  to 
treat  several  of  these  hemorrhages  soon  makes  up  his 
mind  that  it  is  far  from  being  a  simple  matter.  The 
teaching  in  college  and  in  our  text  books  on  this  sub- 
ject has  been  far  from  satisfactory  and  is  really  worthy 
of  but  little  notice. 

As  with  so  many  other  apparently  trivial  conditions, 
hemorrhage  from  the  palatine  artery  is  given  but  lit- 
tle attention  in  the  various  departments  of  surgery. 
The  fact  is  that  this  hemorrhage  is  a  true  clinical 
entity,  occuring  with  more  or  less  regularity  in  a  quite 
typical  form.  This  is  especially  true  in  localities 
where  old  time  empirics  still  predominate,  and  ''bleed- 
ing" is  resorted  to  for  most  ailments.  Probably  nine- 
ty-five per  cent  of  all  cases  of  hemorrhage  from  the 
palatine  artery  which  come  into  the  veterinarian's 
hands  are  the  result  of  empirical  treatment  either  by 

43 


44  SPECIAL  VETBRINIARY  THERAPY 

the  owner  of  the  horse  or  by  non-graduate  veter- 
inarians ;  such  as  cutting  "lampas,"  bleeding  for  colics, 
for  sun-stroke  and  what-not.  Rarely  a  hemorrhage 
of  this  kind  occurs  accidentally,  but  nearly  always  it  is 
brought  on  by  some  such  ignorant  practices  as  those 
enumerated  above. 

The  first  thing  of  importance  to  learn  about  the 
control  of  bleeding  from  this  artery  is  the  fact  that  it 
can  almost  be  turned  into  a  pleasant  and  somewhat 
scientific  job  if  the  horse  is  first  cast.  It  is  not  neces- 
sary to  make  a  preliminary  examination.  From  the 
history  given  you  by  the  client  you  can  tell  just  what 
you  have  to  deal  with,  and  the  first  move  on  the  veter- 
inarian's part  should  be  to  cast  the  patient  as  promptly 
as  possible. 

Bandages,  compresses,  tourniquets,  styptics  and 
all  other  mechanical  agents  have  no  place  in  the  treat- 
ment of  this  condition.  A  curved  needle,  heavy, 
braided  silk  and  a  good  needle-holder  are  the  weapons 
with  which  to  fight  this  rapidly  fatal  injury. 

When  the  horse  has  been  cast  a  man  is  instructed 
to  kneel  on  the  animal's  neck,  just  behind  the  ear, 
grasp  the  muzzle  firmly  with  both  hands  and  .turn  the 
nose  upwards. 

If  a  speculum  is  at  hand  it  should  be  in  place  as 
it  makes  the  performance  of  the  veterinarian's  part 
more  simple.  If  no  speculum  is  available,  the  assist- 
ant holding  the  head  must  firmly  grasp  the  tongue 
with  one  hand,  drawing  it  tensely  out  and  against  the 
check.  The  veterinarian  now  locates  the  incision  or  the 
tear  in  the  palate  from  which  th«  hemorrhagt  comes ; 


PALATINE  ARTERY  HEMORRHAGE  45 

by  swabbing  with  a  thick  wad  of  cotton  he  can  do 
this  easily. 

Having  located  the  opening,  one  interrupted  or 
ordinary  stitch  is  put  through  the  soft  tissue  of  the 
palate  transversely  across  the  trauma  (note  I  say 
transversely  across  the  traumu,  not  the  artery)  and  as 
nearly  over  the  course  of  the  palatine  artery  as  possi- 
ble. It  is  not  necessary  to  engage  the  artery  in  the 
stitch.  The  stitch  is  then  tied  "good  and  snug"  but 
not  too  tight. 

In  most  cases  of  this  kind,  resulting  from  the 
"bleeder's"  knife,  this  one  stitch  is  sufficient  and  the 
hemorrhage  stops  immediately.  Reference  to  physi- 
ology and  to  histological  anatomy  explain  the  reason 
for  this  modus  operandi. 

It  is  indeed  rare  that  a  case  is  presented  which  re- 
quires more  than  one  stitch  if  it  is  properly  and  cor- 
rectly placed.  Care  must  be  used  in  starting  the 
needle  so  that  it  is  not  buried  too  deeply  and  the  point 
broken  on  the  hard  structures  above.  Aim  to  bury 
the  point  about  one-eighth  of  an  inch  and  bring  it 
level  with  the  surface  for  a  considerable  distance  un- 
der the  hard  palate  (depending  on  the  width  or  "gape** 
of  the  cut)  before  turning  it  upwards  again  to  engage 
the  other  side  of  the  wound.  In  other  words,  the 
suture  should  go  in  and  come  out  at  least  three-eighths 
of  an  inch  from  each  edge  of  the  incision.  A  full- 
curved  needle  and  medium-heavy  braided  silk  should 
be  used.     A  needle  holder  is  almost  indispensable. 

It  is  possible  to  carry  out  this  little  operation  with- 
out casting  the  horse ;  but  in  this  position  it  is  about 


46  SPECIAL  VETERINARY  THERAPY 

the  most  disagreeable,  bloody  piece  of  work  in  veteri- 
nary practice.  It  is  almost  impossible  to  hold  the 
animal's  head  still,  the  awkward  position  in  which  the 
work  has  to  be  performed  and  the  constant  slinging 
of  blood  by  the  movements  of  the  head  and  tongue 
make  it  far  from  pleasant. 

Much  time  can  be  saved,  (as  well  as  wear  and  tear 
on  the  veterinarian's  temper)  and  a  better  operation 
performed  by  casting  the  horse  in  the  beginning. 

No  attention  is  given  the  stitch  for  at  least  twenty- 
four  hours  thereafter.  On  the  second  day  it  and  the 
parts  around  it  are  sprayed  or  swabbed  with  tincture 
of  iodine  and  on  the  third  day  it  may  be  removed.  No 
harm  results  even  if  nothing  further  is  done  and  the 
stitch  allowed  to  slough  out. 

In  some  of  these  cases  the  animal  is  almost  exsan- 
guinated by  the  time  the  veterinarian  arrives  and  gets 
the  hemorrhage  under  control.  It  is  always  well  to 
administer  restoratives  and  put  the  animal  on  a  course 
of  iron  and  other  tonics  for  several  weeks. 


Shortening  the  Duration  of  Partur- 
ient Paresis. 

The  treatment  under  discussion  has  for  its  object 
more  rapid  recovery  in  cases  of  milk  fever.  It  is  not 
a  treatment  in  itself,  but  a  measure  supplementary 
to  the  distention  of  the  udder  with  air. 

It  frequently  occurs  that  cases  of  parturient  paresis 
progress  rapidly  and  favorably  to  a  certain  stage  and 
then  no  further  progress  towards  complete  recovery 
seems  to  be  made.  The  cow  lies  upon  her  chest,  ap- 
pears bright  but  refuses  to  get  up.  If  a  sufficient 
period  of  time  is  allowed,  say  two  or  three  hours 
more,  she  eventually  gets  up.  However,  the  veterina- 
rian in  general  practice  would  like  to  see  the  patient 
on  her  feet  before  leaving  her.  Two  hours  is  not  too 
long  to  remain  with  a  case  of  this  kind,  especially  if 
results  can  be  fully  accomplished  in  this  time. 

The  treatment  which  I  can  highly  recommend  for 
this  purpose  was  discovered  through  efforts  on  my 
part  to  bring  about  a  rise  of  temperature  to  normal. 
It  is  a  clinical  fact,  despite  teachings  to  the  contrary, 
that  with  few  exceptions  these  cases  have  a  sub- 
normal temperature.  I  have  made  it  a  regular  prac- 
tice to  take  the  temperature  in  cases  of  parturient 
paresis  and  I  am  positive  that  nine  out  of  ten  have  a 
sub-normal  temperature,  ranging  from  96°  to  99°   F. 

Along  this  line  I  have  demonstrated  that  as  soon 
as  the  patient's  temperature  approaches  the  normal 
there  is  no  trouble  about  getting  her  to  stand  up.     We 


48  SPECIAL  VETERINARY  THERAPY 

have  little  or  no  trouble  in  calling  to  mind  agents 
which  will  reduce  the  temperature;  most  of  us  can 
name  a  half-dozen  with  hardly  a  thought.  But,  let 
some  one  ask  us  for  something  out  of  the  materia 
medica  which  will  quickly  and  quite  surely  raise  ani- 
mal temperature !     That  makes  us  think. 

Atropin  will  do  this,  will  do  it  certainly  and 
promptly.  Before  I  adopted  this  line  of  treatment, 
my  method  in  parturient  paresis,  after  inflating  the 
udder,  was  to  give  from  a  quarter  to  a  whole  grain  of 
strychnin  hypodermatically. 

I  have  now  discarded  the  strychnin  injection  for 
one  of  a  quarter  to  a  half  grain  of  atropin  sulphate. 
The  consequence  is  that  where  I  used  to  make  sev- 
eral visits  to  these  cases,  hardly  ever  getting  one  to 
arise  short  of  six  hours,  I  now  remain  with  the  case 
just  about  two  hours  and  nearly  every  time  the  cow 
is  on  her  feet  before  I  drive  away.  Occasionally  one 
refuses  to  respond,  but  after  using  the  treatment  a 
few  times,  it  will  be  quite  easy  to  pick  out  those  cases. 
Those  in  which  the  symptoms  of  coma  remain  over 
an  hour  and  are  slow  to  brighten  up  will  take  a 
somewhat  longer  time.     A  few  cases  will  teach  this. 

My  method  is  to  inflate  the  udder  and  then  give 
the  atropin.  When  this  is  done,  I  have  the  animal 
virtually  smothered  in  all  the  blankets  in  the  stable. 
I  take  the  temperature  every  fifteen  minutes.  As 
soon  as  it  approaches  normal  an  attempt  is  made  to 
make  the  cow  get  up,  assistance  being  given  by  the 
tail.  The  quickest  recovery  I  have  obtained  in  this 
manner  was  in  one  hour  and  thirty  minutes. 


Obstetrical  Paralysis  in  the  Cow, 

This  is  a  condition  which  follows  only  those  cases 
of  parturition  in  which  the  calf  is  exceedingly  large, 
or  cases  of  dystokia,  during  the  correction  of  which 
the  cow  is  subjected  to  prolonged  handling  and  bruis- 
ing. It  is  rarely,  if  ever,  seen  after  normal  delivery 
or  after  cases  of  minor  dystokia. 

The  ideal  circumstances  for  the  development  of 
this  condition  consist  in  prolonged  labor  due  to  an 
abnormally  large  fetus.  The  usual  history  is  that  the 
cow  was  down  during  the  birth  and  has  not  been  able 
to  get  up  since,  or  that  she  went  down  very  soon  after 
the  calf  was  delivered  and  is  unable  to  arise. 

These  cases  can  not  very  easily  be  confused  with 
parturient  paresis  because  the  entire  symptomatology 
in  obstetrical  paralysis  is  confined  to  the  inability  of 
the  cow  to  get  up.  In  every  other  way  the  animal  is 
normal ;  no  sign  of  coma  or  indisposition  in  the  least. 
The  animal  eats  and  drinks  and  looks  well  in  every 
way.  The  most  careful  examination  will  bring  out 
nothing  of  value  in  diagnosis,  except  that  usually  the 
tumefied  condition  of  the  vulva  gives  evidence  of  the 
difiicult  labor. 

The  history  in  these  cases  determines  the  diag- 
nosis :  A  very  large  calf ;  much  pulling ;  long  time  in 
effecting  delivery.  Sometimes  these  cases  supervene 
on  cases  of  dystokia  which  the  veterinarian  himself 
has  been  called  to  relieve  and  it  is  on  this  point  that 
I  want  to  call  especial  attention  in  this  chapter. 

It  has  been  my  experience  that  obstetrical  paraly- 
sis will  not  develop  in  these  cases  where  the  cow,  if 

49 


50  SPECIAL  VETERINARY  THERAPY 

lying  when  delivery  is  effected,  is  immediately  made 
to  rise.  Every  means  must  be  used  to  get  the  animal 
upon  her  feet  at  once  and  v^hen  this  has  been  done, 
someone  should  remain  present  to  see  to  it  that  she 
remains  up  for  at  least  two  hours,  during  which  time 
a   little   v/alk   should   be   given   every  twentyminutes. 

If  the  cow  is  on  her  feet  when  the  calf  is  delivered 
every  effort  should  be  made  to  keep  her  up  for  at 
least  two  hours,  walking  her  a  short  distance  every 
ten  or  twenty  minutes  during  this  time. 

I  can  sincerely  recommend  this  as  a  certain  pre- 
ventive of  this  condition,  a  condition  which  is  very  un- 
satisfactory to  treat.  Once  obstetrical  paralysis  is 
fully  devoleped,  a  guarded  prognosis  must  always  be 
given. 

Some  of  these  cases  lie  around  in  this  condition 
for  three  or  four  weeks  and  then  die.  Others  lie 
around  just  as  long  and  recover.  Sometimes  the  con- 
dition terminates  in  complete  recovery  within  three 
or  four  days  and  I  have  known  them  to  terminate 
fatally  also,  in  an  equally  short  period.  Recovery  is 
the  rule,  but  the  duration  of  the  period  of  recum- 
bency is  so  varied  and  so  indefinite  that  statements 
on  the  part  of  the  veterinarian  forecasting  the  termi- 
nation must  be  given  guardedly. 

Probably  the  best  and  most  prompt  effect  in  treat- 
ing cases  which  have  been  allowed  to  develop  this 
condition  (I  say  allowed  to  develop  it  because  it  can 
certainly  be  prevented)  is  obtained  by  frequent  vaginal 
douching  with  hot  water  containing  just  a  trace  of 
fluid  extract  of  belladonna.  This  in  conjunction  with 
strychnine  or  nux  vomica  administered  internally  is 
rational  and  quite  satisfactory. 


Protracted  or  Prolonged  Colics, 

Nearly  all  practitioners  of  veterinary  medicine 
have  had  cases  of  abdominal  pain  which  were  difficult 
to  terminate. 

Frequently  a  case  presents  almost  typical  signs 
of  acute  indigestion,  or  possibly  of  a  simple  spasmodic 
colic,  or  of  mild  impaction.  The  treatment,  which  is 
usual  in  such  cases,  is  given  and  while,  possibly,  some 
temporary  improvement  is  shown  the  case  slowly 
develops  certain  symptoms  which  are  atypical  and 
"hang  fire." 

We  continue  our  treatment  from  stomach  tube  to 
eserine  and  everything  that  could  possibly  be  indi- 
cated. If  we  have  profited  by  former  experience  with 
cases  of  this  kind,  we  go  slowly  as  soon  as  we  recog- 
nize what  we  have ;  we  begin  a  sort  of  "watchful  wait- 
ing" process;  and  the  horse  finally  recovers.  Before 
we  had  profited  by  experience,  with  these  cases,  we 
kept  up  our  treatment  continuously,  we  did  too  much, 
and  we  lost  the  patient. 

It  is  my  opinion  that  in  all  of  these  cases  a  local- 
ized enteritis  or  gastritis  has  developed,  either  from 
excessive  pressure  on  a  small  area  from  gas  or  from 
coprostasis.  This  area  may  be  very  small,  possibly 
no  more  than  a  few  inches  square,  as  I  have  noted 
repeatedly  on  post  mortem  examination  in  cases  which 
died  from  typical  attacks  of  acute  indigestion. 

If  the  veterinarian  desists  from  administering  fur- 
ther heroic  treatment  as  soon  as  he  realizes  that  he 
has  a  case  of  this  kind  in  hand,  the  process  stops  and 
recovery  supervenes.     If,  on  the  other  hand,  he  does 

51 


52  SPECIAL  VETERINARY  THERAPY 

not  recognize  the  condition  and  continues  with  his 
active  medicaments,  he  helps  to  bring  about  exten- 
sion of  the  inflamed  area,  causing  it  to  assume  such 
proportions  that  death  must  supervene. 

I  have  worked  out  a  prescription  for  such  cases  as 
these  which  has  given  me  very  much  satisfaction  and 
I  can  fearlessly  recommend  it.     This  is  it: 

Hexamethylenamine    3  ij 

F.  E.  Belladonna  Rad.  ...l  ^^  3  j 

Tr.  Capsicum J 

F.  E.  Passiflora  Incarnata  5  j 

Aqua  q.  s.  ad 5  ij 

The  hexamethylenamine  is  first  dissolved  in  the 

water  and  then  mixed  with  the     other    ingredients. 

This  is  given  at  one  dose  in  capsules  or  with  syringe 

and  a  similar  dose  is  given  every  two  hours  for  three 

or  four  doses,  if  necessary. 

This  treatment  is  intended  solely  to  relieve  inflam- 
mation and  the  pain  produced  thereby,  and  it  gives 
fine  results  in  the  cases  for  which  it  is  recommended. 

A  very  important  point  in  the  after-care  of  cases 
of  this  kind  lies  in  absolute  abstinence  from  all  food 
for  at  least  twenty-four  hours  after  all  signs  of  pain 
have  left.     Nothing  but  water  should  be  allowed. 

If  it  should  occur  that  the  veterinarian  has  erred 
in  diagnosis  by  failing  to  recognize  a  volvulus  or  an 
invagination,  he  is  doing  no  harm.  Even  in  such 
cases,  whether  a  correct  diagnosis  is  made  or  not,  the 
horse  has  a  better  chance  for  his  life  with  the  fore- 
going treatment,  by  a  wide  margin,  than  he  would 
have  if  the  usual  colic,  acute  indigestion  or  impaction 
treatments  were  kept  up. 


Intravenous  Medication. 

It  is  not  my  purpose  to  take  up  the  entire  subject 
of  intravenous  medication,  nor  to  give  the  reader  any- 
new  thought  or  method  along  this  line.  I  simply 
wish  to  register  a  warning  note  against  the  indis- 
criminate use  of  medicaments  by  direct  instillation 
into  the  blood  stream. 

In  this,  the  average  graduate  veterinarian  allows 
his  best  judgment  and  his  fundamental  knowledge  of 
the  rudiments  of  his  profession  to  fail  him.  In  this, 
the  indiscriminate  use  of  intravenous  medication,  he 
infringes  most  unpardonably  on  the  kindness  of  na- 
ture and  commits  his  worst  offences  on  the  side  of 
quackery.  Were  this  all  it  would  not  yet  be  so  seri- 
ous. It  is  the  harmful  and  uncertain  effects  which 
such  treatment  has  on  the  future  well-being  of  the 
patient  which  makes  this  subject  really  worthy  of  at- 
tention. 

It  is  only  rarely  that  these  harmful  effects  are 
noted  immediately  and  seldom  if  ever  are  they  traced 
to  their  causative  factor  when  they  ultimately  make 
their  appearance. 

I  remember  only  one  instance  where  I  noted  an 
untoward  effect  within  a  short  time.  It  exhibited  it- 
self as  a  blindness  and  facial  paralysis  within  twenty- 
four  hours. 

Many  are  the  conditions,  of  varied  pathological 
significance,  which  may  follow  at  long  intervals  upon 
the  intravenous  injection  of  intolerable  or,  improperly 
administered,  tolerable  medicaments.  Chief  among 
these  are  embolism  with  its  multiplicity  of  local  phe- 

63 


54  SPECIAL  VETERINARY  THERAPY 

nomena,  especially  lameness  and  various  demonstra- 
tions of  trophic  nerve  disturbance. 

In  choosing  agents  for  exhibition  by  the  blood 
stream,  we  should  respect  the  delicacy  of  the  tissue 
with  which  the  agent  comes  into  such  intimate  con- 
tact. We  should  remember  our  physiology  and  our 
histology  enough  so  that  we  do  not  ignore  the  fact 
that  of  all  animal  tissue,  blood  will  least  bear  contact 
or  handling  in  any  form.  We  should  not  forget,  espe- 
cially, the  microscopically  delicate  net-works  of  capil- 
laries and  terminal  vessels  through  which  it  must 
pass  unhindered.  We  should  remember  how  delicate 
is  the  physiologic  chemistry  of  the  blood  and  how  lit- 
tle it  takes  to  disturb  the  equilibrium  of  this  vital 
formula.  All  too  frequently,  the  veterinarian  forgets 
his  early  teaching  on  this  subject  and  many  times 
the  ultimate  harm  done  the  patient  heavily  outweighs 
the  good. 

The  veterinarian  can  gain  much  by  keeping  track 
of  the  cases  in  which  he  uses  intravenous  injections. 
In  most  cases  after  varied  intervals,  the  patient  de- 
velops some  form  of  lameness,  some  apparent  func- 
tional disturbance,  or  some  puzzling  atrophy,  which  is 
hard  to  handle.  Lameness  such  as  follows  this  pro- 
cedure is  usually  obscure,  difficult  of  diagnosis  and 
resistant  to  treatment. 

If  we,  as  veterinarians,  would  bear  in  mind  that 
physicians,  who  have  every  facility  to  make  intra- 
venous medication  ideal,  consider  it  a  measure  to  be 
used  only  in  dire  extremes,  we  would  not  go  about 
it  so  carelessly  and  promiscuously. 


Subspinal  Anesthesia- Abdominal 
Operations. 

This  anesthesia  is  obtained  by  injecting  mild,  non- 
toxic solutions  of  local  anesthetics,  of  which  stovaine 
is  the  best,  into  the  peritoneal  cavity.  Immediately 
after  the  solution  has  been  injected  the  dog  is  placed 
in  the  dorsal  recumbent  position  and  held  in  this  po- 
sition until  the  anesthesia  is  established,  requiring 
usually  about  fifteen  minutes. 

The  anesthesia  obtained  in  this  manner  affects  the 
entire  abdominal  viscera  and  is  so  complete  as  to  per- 
mit of  free  handling  or  incising  or  dissection  of  the 
parts.  The  skin  remains  sensitive  and  the  animal  is 
wide  awake.  The  failure  of  the  skin  anesthesia  can 
be  overcome  by  injecting  a  little  of  the  solution  sub- 
cutaneously  at  the  seat  of  incision.  Anesthesia  by 
this  method  prevails  for  several  hours  if  stovaine  is 
used  and  there  are  no  bad  after-effects. 

In  occasional  cases  an  obturator  paralysis  is  tem- 
porarily established,  lasting  for  three  or  four  hours. 
This  is  evidenced  by  a  straddling  or  sprawling  gait 
behind  when  the  dog  is  placed  on  his  feet  after  the 
operation.  It  seems  that  he  finds  it  impossible  to 
abduct  the  pelvic  limbs.  This  paralysis  lasts  only  so 
long  as  the  anesthetic  is  active,  from  one  to  four 
hours. 

ss 


56  SPECIAL  VETERINARY  THERAPY 

The  advantages  of  this  method  of  anesthetizing 
are  many.  No  attention  need  be  given  the  patient 
after  making  the  injection,  therefore  no  assistant  is 
required  for  this  part  of  the  operation.  No  shock 
follows  even  the  most  prolonged  and  extensive  opera- 
tive interference  under  this  anesthesia;  there  is  no 
post-operative  nausea  and  the  animal  requires  no 
watching  as  is  the  case  when  it  is  reviving  from  pro- 
found chloroform  anesthesia. 

The  technic  is  simple,  the  point  of  greatest  im- 
portance being  cleanliness. 

For  a  dog  weighing  twenty-five  pounds  one  ounce 
of  a  one  per  cent  solution  of  stovaine  is  sufficient. 
The  solution  should  be  sterile  and  used  at  blood  heat, 
a  little  more  than  luke  warm.  Half  an  ounce  is  in- 
jected into  the  peritoneal  cavity  on  each  side  of  the 
median  line,  making  the  needle  enter  just  in  front  of 
the  brim  of  the  pelvis  near  the  fold  in  the  flank.  The 
abdominal  muscles  are  most  favorable  for  puncture 
at  that  point.  A  very  fine  needle  and  ordinary  hypo- 
dermic syringe  can  be  used.  A  little  practice  makes 
it  possible  to  determine  without  much  difficulty  when 
the  needle  enters  free  in  the  abdominal  cavity.  The 
solution  must  not  enter  an  intestine  or  other  organ 
but  must  be  placed  within  the  peritoneal  cavity. 

As  soon  as  the  injection  is  completed  the  dog  is 
turned  flat  on  his  back  and  forced  to  remain  in  this 
position  by  hobbles  or  other  means.  In  fifteen  min- 
utes the  operating  can  begin. 

If  it  is  desired  to  anesthetize  the  skin  only  for  the 
primary  incision,  an  ethyl  chloride  spray  may  be  used. 


SUBSPINAL  ANESTHESIA  57 

If  it  is  desired  to  continue  the  skin  anesthesia  until 
the  end  of  the  operation,  a  few  drops  of  the  stovaine 
solution  injected  along  the  line  of  incision  will  give 
this  result. 

In  case  obturator  paralysis  supervenes,  the  dog  is 
kept  quiet  for  several  hours  after  operation.  No  treat- 
ment is  necessary,  as  it  always  passes  off  in  a  few 
hours. 

This  method  of  anesthetizing,  although  used  by 
some  veterinarians  for  a  number  of  years,  is  in  direct 
accord  with  the  most  recent  progress  along  surgical 
lines,  namely  anoci-association  or  the  prevention  of 
surgical  shock.  Professors  Crile  and  Lower  have 
just  completed  a  valuable  monograph  on  anoci-associ- 
ation which  is  now  in  the  hands  of  the  publishers. 
(W.  B.  Saunders  Publishing  Company,  Philadelphia.) 


The  Treatment  of  Tetanus  with 
Passiflora  Incarnata. 

Tetanus  is  one  of  the  several  conditions  which 
affect  veterinary  patients  for  which  there  is  as  yet  no 
generally  accepted  treatment.  Antitetanic  serum  has 
fully  established  its  worth  as  a  sure  prophylactic  but 
there  is  much  doubt  as  to  its  real  value  when  the 
symptoms  of  the  disease  are  once  in  evidence. 

The  accepted  and,  at  the  present  time,  the  method 
most  in  use  when  serum  is  used  in  the  treatment  of 
this  condition,  is  the  injection  of  only  one  or  two  im- 
mense doses  in  the  outset  of  the  treatment.  It  is 
quite  generally  believed  that  after  this  the  further  ad- 
ministration of  serum  is  of  no  benefit.  Occasionally 
cases  are  reported  in  which  a  rapid  recovery  appar- 
ently follows  the  injection  of  antitetanic  serum.  It  is 
doubtful  whether  these  cases  are  cases  of  genuine 
tetanus.  Real  tetanus  due  to  infection  by  Nicolaier's 
bacillus  is  always  a  disease  which  persists  for  a  long 
time.  A  recovery  in  four  wxeks  is  considered  rapid ; 
usually  it  requires  six  or  eight  weeks. 

In  the  treatment  of  this  disease,  we  must  rely  al- 
most wholly  upon  agents  which  will  reduce  the 
nervous  excitability,  and  the  entire  treatment  of  teta- 
nus today  is  symptomatic,  with  the  exception  of  the 
local  treatment  of  the  wound,  when  it  can  be  found. 

Usually  the  attending  veterinarian  is  satisfied  with 
the  condition  of  his  patient  in  this  disease,  if  he  can 
keep  his  patient  free  from  spasmodic  m.uscular  con- 
tractions, trisms  especially  affecting  the  masseters  and 

S9 


60  SPECIAL  VETERINARY  THERAPY 

cervical  region.  Since  1905  I  have  been  using  the 
fluid  extract  of  Passiflora  incarnata  for  tetanus  spasms. 

The  one  great  advantage  that  this  drug  has  in  this 
condition  lies  in  the  fact  that  it  can  be  given  indefi- 
nitely in  the  same  dosage  without  the  effect  becoming 
less.  In  other  words,  tolerance  for  the  action  of  the 
drug  does  not  develop ;  an  ounce  gives  the  same  effect 
at  the  end  of  two  weeks'  continuous  treatment  as  it 
does  from  the  first  dose. 

The  action  of  this  drug  seems  to  be  selective  in 
this  disease.  It  can  not  be  described  as  a  hypnotic 
nor  as  a  narcotic  action.  It  seems  to  have  a  clear  seda- 
tive effect,  restricting  its  power  to  the  abatement  of 
the  nerve  irritability.  The  patient  shows  only  this 
effect;  no  evidence  of  drowsiness  or  inertia. 

My  method  is  to  arrange  matters  so  that  the  horse 
will  be  given  a  full  ounce  of  the  drug  every  three 
hours,  day  and  night,  during  the  first  forty-eight 
hours.  By  this  time  the  full  physiologic  effect  of  the 
drug  is  obtained.  This  effect  may  then  be  maintained 
indefinitely  by  giving  an  ounce  every  three  or  four 
hours  during  the  day,  beginning  early  in  the  morning 
and  stopping  late  at  night.  This  course  should  be 
kept  up  day  after  day  until  there  is  such  improvement 
that  only  an  occasional  dose  need  be  given  during  each 
day.  The  drug  may  be  given  undiluted  with  a  dose 
syringe. 

Usually  the  horse  is  fairly  relaxed  from  this  treat- 
ment within  a  day  or  two,  and  most  of  my  cases  are 
almost  fat  by  the  time  they  recover.  With  other 
forms  of  treatment,  it  has  been  impossible  for  me  to 
terminate  a  well  marked  case  of  tetanus  with  the  horse 
in  good  flesh ;  more  often  than  not  they  were  wasted 
to  only  a  shell  of  their  former  condition. 


Contagious  Abortion  in  Cattle. 

Remarks  on  this  subject  will  be  confined  to  the 
use  of  methylene  blue  as  a  treatment. 

As  the  methylene  blue  treatment  is  a  comparatively 
recent  addition  to  our  weapons  against  contagious 
abortion,  my  experience  with  the  treatment  covers  a 
short  period  of  time,  about  one  year.  Elsewhere  in 
this  work  I  have  advocated  only  thoroughly  tried  out 
treatments,  treatments  that  I  have  employed  over 
several  years  and  in  a  number  of  cases  sufficiently 
large  to  speak  with  authority  concerning  them.  It  is 
therefore  with  some  hesitation  that  I  recommend  this 
comparatively  little  tried  treatment. 

During  this  period  I  had  an  opportunity  to  give 
the  treatment  a  fair  test  in  three  herds  in  which  the 
disease  had  a  strong  foot-hold,  having  existed  con- 
tinuously in  one  of  the  herds  for  over  five  years,  dur- 
ing which  time  every  known  treatment  had  been  used 
and  had  failed  to  check  it.  Under  the  methylene  blue 
treatment  this  herd  has  apparently  been  absolutely 
purged  of  the  trouble,  all  cows  going  to  full  term  with 
live  calves  last  season  and  not  a  single  abortion  occur- 
ing  since  the  treatment  was  given.  In  the  second 
herd,  as  high  as  three  cows  aborted  in  one  week  and 
the  infection  seemed  to  be  especially  virulent.  Under 
methylene  blue  treatment,  the  abortions  promptly 
stopped  and  apparently  the  herd  is  clean. 

61 


62  SPECIAL  VETERINARY  THERAPY 

The  third  herd  had  been  infected  for  about  two 
years,  the  disease  was  well  established  and  apparently 
beyond  control.  In  this  herd  also  no  further  abortions 
have  occured  since  the  treatment  was  given. 

This  experience  is  very  limited  on  which  to  base 
an  opinion,  but  considering  the  conditions  and  the 
uniformity  of  results,  from  these  three  reports,  I  must 
of  necessity  say  that  my  results  with  the  treatment 
have  been  one-hundred  per  cent  perfect.  Some  of  my 
colleagues  have  not  found  the  treatment  so  satisfac- 
tory, but  I  find  on  looking  into  the  matter  that  my 
method  of  using  the  treatment  has  differed  much  from 
theirs. 

Comparing  my  method  with  that  of  others,  I  would 
call  mine  an  "intensive"  treatment.  I  use  larger  doses 
than  others  use  and  give  them  more  frequently.  My 
system  consists  of  giving  the  methylene  blue  in  half- 
ounce  doses,  once  daily  for  six  days.  I  then  allow  a 
week  to  pass  without  treatment  and  then  give  one- 
half  ounce  every  other  day  until  another  six  doses 
have  been  given.     This  completes  the  treatment. 

I  give  the  methylene  blue  in  capsules  with  a  balling 
gun,  half  an  ounce  to  each  cow  as  described  above. 
If  there  is  a  bull  in  the  herd,  he  gets  the  same  treat- 
ment. Here  is  another  place  where  my  method  dif- 
fers from  others ;  I  treat  the  bull  the  same  as  the  cows. 
Possibly  the  differences  in  my  method  are  the  points 
that  have  so  far  made  the  treatment  one-hundred  per 
cent  perfect  for  me.  I  have  been  using  doses  about 
ten  or  more  times  larger  than  were  at  first  recom- 
mended by  the  discoverers  of  the  treatment.     I  have 


CONTAGIOUS   ABORTION   IN    CATTLE  63 

seen  absolutely  no  bad  effects  at  all  from  such  dosage. 

During  the  week  which  elapses  between  the  two 
treatments,  I  see  to  it  that  the  entire  cow  stable  and 
cow  yard  are  thoroughly  renovated.  The  stable  is 
then  thoroughly  disinfected  and  at  once  white-washed. 
If  the  cow-yard  contains  an  old  manure  pile,  it  is  to 
be  taken  out  and  used  on  land  where  the  cattle  are  not 
likely  to  graze  at  any  time.  I  allow  no  outside  cows 
to  be  bred  to  the  herd  bull  and  new  additions  to  the 
herd  are  given  the  same  treatment  as  the  infected 
animals  whether  they  are  known  to  have  the  disease 
or  not. 

My  limited  experience  with  this  treatment  leads 
me  to  believe  that  we  have  in  methylene  blue  almost 
a  specific  against  this  disease.  Further  experience 
may  enable  us  to  so  perfect  the  method  of  using  this 
treatment  to  an  extent  that  it  will  be  quite  uniformly 
successful. 

The  interesting  point  with  this  treatment  appears 
in  the  fact  that  in  the  three  herds  in  which  I  used  it 
the  disease  seemed  to  stop  immediately,  no  abortions 
occuring  after  the  treatment  was  once  under  way. 
In  one  herd  a  cow  aborted  on  the  day  treatment  waa 
begun,  but  there  were  no  abortions  later. 


Choke  in  the  Ox- 

Choke  in  cattle  differs  very  much  from  the  same 
condition  in  horses  in  so  far  as  treatment  is  concerned 
and  also  as  regards  the  nature  of  the  agents  producing 
the  choke. 

In  the  cow  probably  most  chokes  are  from  solid 
bodies,  such  as  portions  of  vegetables  and  other  solid 
food.  These  block  the  esophagus  chiefly  because  their 
dimensions  exceed  its  calibre. 

Choke  in  cows  is  usually  a  more  threatening  ail- 
ment than  it  is  in  horses;  the  symptoms  are  more 
acute.  In  addition,  tympanites  is  a  common  compli- 
cation. The  treatment  of  choke  in  cattle  is  almost 
wholly  mechanical  or  surgical. 

When  the  offending  body  is  in  the  cervical  portion 
of  the  esophagus,  it  can  usually  be  plainly  felt  by 
palpating  with  the  fingers.  Sometimes  the  body  is 
so  large  that  it  produces  a  bulge  in  the  esophagus 
which  can  be  plainly  seen. 

If  the  veterinarian's  examination  locates  the  body 
in  the  region  of  the  pharynx  or  just  below  it,  an  effort 
should  be  made  to  extract  it  through  the  mouth  with 
the  hand  while  an  attendant  attempts  to  gently  push 
the  body  closer  to  the  pharynx.  When  this  attempt 
fails,  it  is  advisable  to  leave  the  patient  alone  for  a 
number  of  hours  in  a  stall  where  only  water  is  to  be 
had.  In  many  cases  where  the  offending  body  is  in 
the  upper  third  of  the  esophagus,  the  object  is  ex- 
es 


66  SPECIAL  VETERINARY  THERAPY 

pelled  spontaneously  in  a  few  hours.  I  reported  a  case 
in  the  American  Journal  of  Veterinary  Medicine  (April, 
1914),  which  illustrates  such  an  occurence. 

In  the  horse,  the  mass  of  food  causing  the  choke 
can  pass  only  towards  the  stomach.  In  the  cow,  re- 
covery, many  times,  follows,  from  regurgitation  of  the 
obstruction.  This  is  a  point  which  must  not  be  over- 
looked in  treating  cattle  for  choke. 

If,  in  a  given  case,  the  obstruction  has  not  been 
dislodged  after  eight  or  ten  hours  of  "watchful  wait- 
ing" a  probang  may  be  used  cautiously.  If  the  object 
is  not  quite  easily  moved  by  the  probang,  if  it  resists 
moderate  repulsion,  this  means  of  treatment  should 
be  discontinued  at  once  and  esophagotomy  performed. 
This  applies,  of  course,  only  to  cases  in  which  the 
object  is  in  the  cervical  portion  of  the  esophagus.  In 
cases  of  thoracic  choke  the  probang  treatment  must 
be  patiently  persisted  in  until  something  is  accom- 
plished. 

Esophagotomy  in  cattle  is  a  simple  proceeding  at- 
tended by  fairly  uniform  success.  Even  when  per- 
formed under  trying  handicaps,  I  have  seen  excellent 
results  follow  this  operation.  The  seat  of  operation  is 
directly  upon  the  object.  The  hair  is  shaved,  or  at 
least  clipped,  for  a  considerably  larger  area  than  the 
incision  would  require  and  the  skin  ordinarily  disin- 
fected with  tincture  of  iodine. 

An  incision  is  made  directly  down  onto  the  object 
and  somewhat  longer  through  the  muscle.  When  the 
esophagus  is  reached,  only  a  very  short  incision  is 
first  made  into  it  and  an  endeavor  is  then  made  to  re- 


CHOKE  IN  THE  OX  67 

move  the  objection,  if  a  piece  of  vegetable,  in  sections 
with  forceps. 

If  this  cannot  be  accomplished  after  a  few  trials, 
the  incision  into  the  esophagus  is  enlarged  and  the 
object  removed  en  masse  with  forceps  or  with  the 
fingers.  Usually  it  requires  a  considerable  amount 
of  force  to  extract  the  object  and  one  can  readily  ap- 
preciate why  it  is  so  difficult  to  dislodge  these  objects 
by  means  of  the  probang. 

When  the  body  has  been  removed  the  surgeon 
usually  proceeds  along  lines  which  previous  experi- 
ence, has  taught  him.  In  my  early  experience,  I  took 
pains  in  approximating  the  edges  of  the  esophageal 
incision.  Today,  I  do  not  suture  the  esophagus  at  all. 
It  has  been  my  experience  that  healing  comes  just  as 
quickly  and  just  as  thoroughly  without  sutures  of 
any  kind  excepting  a  continuous  suture  through  the 
muscle  and  skin.  With  the  best  judgment  in  suturing 
the  esophagus,  some  food  always  comes  through  the 
incision  for  a  week  or  ten  days. 

After  the  muscle  has  been  closed  by  suture,  the 
after  treatment  is  confined  to  daily  application  of  an 
antiseptic  solution.  This  should  be  applied  with  a 
syringe  held  a  considerable  distance  from  the  wound 
so  that  the  solution  merely  bathes  the  external  sur- 
face ;  possibly  a  small  amount  of  it  entering  interstices 
between  the  suture. 

The  cow  should  be  fed  nothing  but  very  thin  slops 
and  water  as  long  as  any  particles  of  food  escape 
through  the  wound,  usually  for  about  ten  days  or  two 
weeks. 


68  SPECIAL  VETERINARY  THERAPY 

My  results  from  this  operation  have  been  very 
satisfactory  and  in  no  case  did  a  permanent  esopha- 
geal fistula  become  established.  While  almost  every 
rule  of  legitimate  surgery  is  violated  in  this  method, 
it  gives  good  ultimate  results,  and  just  as  promptly,  as 
are  obtained  when  every  means  is  taken  to  perform  a 
classical  operation. 


Paraplegia  as  a  Sequel  of  Canine 
Distemper. 

This  condition,  following  on  severe  and  prolonged 
attacks  of  distemper  is  seen  frequently.  Its  treatment 
embraces  a  great  variety  of  unsuccessful  therapeutics 
and,  as  a  rule,  veterinarians  have  been  in  the  habit  of 
ordering  the  destruction  of  the  dog  when  this  sequel 
supervened  on  a  case  of  distemper. 

Our  experience  with  this  affection  was  very  dis- 
couraging up  until  the  year  of  1909,  when  a  series  of 
studies  and  experiments,  resulted  in  the  elaboration  of 
a  very  satisfactory  treatment. 

Our  first  success  with  this  treatment  was  reported 
in  the  American  Veterinary  Review  in  that  year  by  my 
brother,,  a  student  at  the  time,  and  myself. 

Our  theory  of  this  condition  as  formulated  at  that 
time  was  that  a  sclerotic  tendency  is  present  in  the 
spinal  cord,  varying  in  degree  with  the  severity  of  the 
symptoms  of  paresis.  Whether  the  theory  is  correct 
or  not  is  immaterial ;  the  treatment  which  we  based 
upon  this  theory  was  successful  and  to  a  certain  ex- 
tent that  proves  the  theory. 

On  this  hypothesis,  we  decided  that  if  we  could 
place  a  bland  and  at  the  same  time  fibrolytic  agent  in 
more  or  less  intimate  contact  with  the  spinal  cord,  we 
could  correct  the  abnormality. 


70  SPECIAL  VETERINARY  THERAPY 

On  these  lines,  our  selection  fell  on  thiosinamine, 
whose  action  on  sclerotic  processes  is  selective.  It 
can  be  obtained  in  sterile,  graduated  ampules,  under 
the  trade  name  of  "Fibrolysin,"  and  it  is  in  this  form 
that  we  use  it.  In  our  early  work  along  this  line,  we 
deemed  it  essential  that  the  drug  be  deposited  sub- 
durally.  Later  we  found  that  the  same  results  could 
be  obtained  by  epi-dural  injections. 

The  modus  operanjdi  is  as  follows,  under  chloro- 
form : 

An  area  of  an  inch  square  over  the  alto-axoid  space 
is  shaved  and  thoroughly  cleaned.  With  a  very  fine 
hypodermic  needle  a  puncture  is  made  straight  down 
onto  the  cord,  passing  the  needle  slowly  in  until  a 
sudden  freedom  from  resistance  gives  evidence  that 
the  point  has  entered  the  neural  canal.  This  is  easy 
to  recognize  after  a  very  little  practice.  The  head  is 
to  be  sharply  flexed  on  the  sternum  while  the  entrance 
is  made  and  until  the  needle  is  withdrawn. 

When  the  characteristic  sensation  of  absence  of 
resistance  is  felt,  the  hypodermic  syringe,  containing 
the  fibrolysin  at  body  temperature,  is  attached  to  the 
needle  and  the  contents  very  slowly  injected.  The 
needle  is  withdrawn  quickly  and  the  seat  of  puncture 
is  then  painted  with  tincture  of  iodine.  This  com- 
pletes the  treatment.  The  dose  is  one  cubic  centi- 
meter of  fibrolysin  to  twenty-five  pounds  of  live 
weight. 

Within  a  few  hours  after  the  injection,  the  animal 
exhibits  typical  symptoms  of  brain  trauma,  delirium 
and  partial  coma.     This  passes  off  in  from  eight  to 


PARAPLEGIA  FOLLOWING  DISTEMPER         71 

twelve  hours  and  almost  immediate  improvement  is 
shown  as  regards  the  general  condition,  paraplegia  and 
inco-ordination.  Even  during  the  first  twenty-four 
hours  following  the  disappearance  of  the  brain  symp- 
toms the  animal  has  better  control  of  his  movements. 
Symptoms  of  chorea  of  certain  muscle  groups  (which 
may  have  been  present)  are  less  frequent  and  less 
severe  and  co-ordination  is  again  becoming  established 
in  the  posterior  parts.  Improvement  progresses  rap- 
idly day  by  day,  until  at  the  end  of  two  weeks,  the 
animal  has  almost  normal  control. 

Tonics  and  warm  quarters  help  to  hasten  final  and 
complete  recovery.  No  attempt  should  be  made  to 
carry  out  this  treatment  except  under  profound 
anesthesia. 

In  our  early  work,  we  used  morphine  narcosis ; 
this  is  contra-indicated  in  view  of  the  brain  symp- 
toms which  follow  the  injection  and,  besides,  the 
anesthesia  is  not  complete  and  therefore  dangerous  in 
this  procedure.  A  slight  jerk  when  the  point  of  the 
needle  is  in  situ  could  do  irreparable  damage. 


Treatment  of  Pneumonia  with 
Sparteine  Sulphate. 

In  the  American  Journal  of  Surgery  (July,  1912), 
there  appeared  an  article  on  the  use  of  sparteine  sul- 
phate in  human  medicine.  The  author  states  in  the 
article  that  it  is  his  opinion  that  poor  results  from  the 
use  of  this  drug  are  due  to  improper  dosage.  He 
recommends  doses  nearly  ten  times  larger  than  are 
usually  considered  proper. 

I  had  given  sparteine  sulphate  a  trial  in  pneu- 
monia as  far  back  as  1905  and  had  discarded  it  for 
more  active  agents.  Upon  reading  the  article  above 
referred  to  I  decided  to  give  the  drug  another  chance 
and  began  to  use  it  again,  but  in  much  larger  doses 
than  previously.  Instead  of  using  only  a  two  or 
three-grain  dose  as  in  our  first  experience  with  the 
drug,  I  began  this  time  to  make  the  average  dose, 
twenty  grains.  And  I  was  very  agreeably  surprised 
at  the  marked  benefit  derived,  especially  in  pneumonia 
in  cattle. 

The  salt  is  very  soluble  and  can  be  made  up  in  solu- 
tion with  water  readily.  I  make  a  solution  of  such 
strength  that  an  ounce  represents  twenty  grains  of 
the  drug,  and  direct  that  an  ounce  be  given  every 
three  or  four  hours.  During  the  past  winter,  I  treated 
a  number  of  cases  of  pneumonia  successfully  with  this 
alone. 

Tl 


74  SPECIAL  VETERINARY  THERAPY 

Sparteine  is  a  safe  heart  tonic  for  this  disease  be- 
cause, while  it  increases  the  force  of  the  heart  action, 
it  does  not  raise  blood  pressure.  I  believe  that  this  is 
its  chief  superiority  over  other  drugs  in  the  treatment 
of  this  disease. 

Besides  its  value  as  a  heart  tonic  it  possesses 
diuretic  properties  and  it  increases  the  appetite.  In 
the  last  respect  it  acts  as  a  bitter  tonic  and  its  effect 
is  quite  the  opposite  of  that  of  digitalis. 

Sparteine  sulphate  can  also  be  administered  hypo- 
dermatically  when  heart  failure  is  imminent,  its  effect 
commencing  within  ten  or  fifteen  minutes,  becoming 
fully  established  in  about  an  hour  and  persisting  from 
three  to  six  hours. 

The  best  system  for  its  application  in  a  case  of 
pneumonia  is  to  give  it  in  solution  by  the  mouth  every 
three  or  four  hours  during  the  day.  Results  are  all 
that  can  be  desired.  Often  the  attack  seems  to  termi- 
nate within  four  or  five  days,  the  temperature  ap- 
proaching normal  and  the  lungs  apparently  clearing 
up. 

I  would  call  attention  again  to  the  fact  that  this 
drug  is  the  ideal  heart  tonic  for  this  disease  because 
it  increases  the  force  of  the  heart  action  without  rais- 
ing blood  pressure.  Given  every  three  or  four  hours, 
twenty  grains  should  not  be  exceeded  as  a  dose;  if 
larger  doses  are  given,  say  twenty-five  to  thirty  grains, 
doses  every  five  or  six  hours  suffice.  On  the  average 
twenty  grains  every  three  or  four  hours  are  better 
than  the  larger  dose  at  longer  intervals. 


Creosote  for  Intestinal  Infections. 

Creosote  is  a  valuable,  but  much  neglected  agent  in 
veterinary  medicine.  Probably  the  chief  reason  for 
this  lies  in  the  fact  that,  because  of  its  disagreeable 
odor,  our  patients  must  either  be  drenched  with  it,  or 
it  must  be  administered  in  capsules.  Most  animals 
refuse  to  eat  it  on  the  feed. 

While  useful  for  a  great  variety  of  diseases  and 
pathologic  conditions,  it  is  in  infectious  conditions  of 
the  intestinal  tract  that  creosote  gives  its  best  per- 
formance. In  various  forms  of  dysentery  and  in  sec- 
ondary intestinal  catarrh,  it  may  be  depended  upon 
without  question. 

For  internal  administration  only  the  beechwood 
creosote  should  be  used.  The  average  dose  for 
horses  can  be  put  at  fifteen  minims,  for  cattle  twenty. 
It  should  always  be  combined  with  a  bland  oil  such  as 
linseed,  cotton-seed  or  castor  oil. 

A  good  capsule  for  acute  scours  is  the  following: 

Creosoti    (Beechwood) M  xv 

Tr.    Capsici    5  i 

Ol.  Cajuput    3  iv 

Ol.  Ricini,  q.  s.  ad 5  i 

M.  et  fiat  capsula. 

Sig. — Give  at  one  dose  for  scours.  This 
may  be  repeated  in  an  hour  if  neces- 
sary. 

In  affections  of  the  intestinal  tract,  in  which  the 

feces  have  a  disagreeable  odor,  creosote  can  be  used 

75 


76  SPECIAL  VETERINARY  THERAPY 

to  advantage,  a  few  doses  overcoming  all  objectionable 
odor.  When  used  in  conditions  which  require  the 
drug  to  be  given  three  or  four  times  daily  the  dose 
should  not  exceed  seven  or  eight  minims.  In  doses  of 
fifteen  minims  repeated  two  or  three  times  at  regular 
intervals  a  vermicidal  effect  will  be  obtained  which 
is  quite  thorough. 


Retained  Secundines  in  Cows. 

Retention  of  the  after-birth  in  cows  is  one  of  the 
most  common  abnormalities  associated  with  preg- 
nancy. This  is  especially  true  in  localities  where  con- 
tagious abortion  prevails. 

From  time  to  time  there  appear  in  our  journals 
reports  of  new,  and  sometimes  long-forgotten  forms 
of  treatment  and  methods  of  removing  after-births. 
When  all  has  been  thoroughly  gone  over  and  tried 
out  in  every  day  practice  it  can  not  be  denied  that 
the  only  safe,  complete  and  satisfactory  removal  of 
a  retained  after-birth  is  by  manual  extraction.  The 
longer  we  are  in  practice,  the  more  surely  we  become 
convinced  of  this. 

The  greatest  discrepancy  in  agreement  among 
veterinarians  lies  in  the  point  relating  to  the  time 
which  should  elapse  after  the  expulsion  of  the  fetus 
before  extraction  of  a  retained  after-birth  should  be 
attempted.  The  period  advocated  varies  from  one 
to  three  days,  with  some  advantages  on  each  side  and 
disadvantages  on  all. 

From  the  standpoint  of  science,  from  the  stand- 
point of  surgery  and  from  the  standpoint  of  milk 
hygiene  twenty-four  hours  is  the  limit  of  time  to 
elapse  between  the  birth  of  the  calf  and  the  removal  of 
the  after-birth.  At  this  time  the  os  is  still  wide  open 
so  that  every  cotyledon  can  be  reached  and  freed  from 
the  encircling  envelope.  Also  at  the  end  of  twenty- 
four  hours,  practically  no  sign  of  tissue  degeneration 
is  yet  evident. 

77 


78  SPECIAL  VETERINARY  THERAPY 

The  ''third-day"  advocates  present  their  side  with 
the  argument  that  it  is  practically  impossible  to  re- 
move the  afterbirth  from  some  of  the  cotyledons  be- 
fore the  third  day.  Even  if  this  v^ere  a  fact,  which 
I  doubt,  it  would  be  better  to  leave  attached  a  few 
small  shreds  of  clean  tissue  which  will  probably  not 
undergo  degeneration  at  all  if  the  uterus  is  carefully 
swabbed,  than  to  allow  the  entire  mass  to  approach  a 
state  of  foul  decomposition,  which  is  always  the  con- 
dition presented  if  three  days  elapse.  By  the  third 
day  the  placental  portion  of  the  secundines  has  al- 
ways degenerated  and  the  uterus  is  a  sticky,  slimy  and 
far  from  pleasant  smelling  organ. 

I  am  thoroughly  aware  of  the  fact  that  from  the 
standpoint  of  manual  labor,  the  third  day  is  the  day  of 
choice.  Gentle,  steady  traction  with  appropriate 
torsion  brings  out  the  envelopes  en  toto.  But  the  de- 
composed, semi-liquid  placental  debris  and  other  dis- 
charges remain.  The  os  has  become  closed  to  such 
an  extent  that  only  two  or  three  fingers  can  enter  and 
it  is  practically  impossible  to  thoroughly  cleanse  the 
organ.  From  every  professional  standpoint,  twenty- 
four  hours  is  a  sufficient  length  of  time  to  wait  before 
resorting  to  manual  removal. 

This  has  been  my  rule  over  a  period  of  more  than 
ten  years  and  out  of  several  hundred  cases,  I  have  yet 
to  lose  the  first  one.  On  the  other  hand,  I  have  had 
deaths  from  waiting  too  long,  sometimes  three  days, 
and  unsatisfactory  terminations  even  after  two  days. 

After  completing  the  removal,  my  method  is  to 
swab  out  the  uterus  with  solid  fists  full  of  absorbent 


FOREIGN  BODIES  7$ 

cotton  after  pumping  in  a  mild  antiseptic  solution. 
By  this  means  a  case  of  this  kind  can  invariably  be 
left  in  a  clean,  comfortable  state.  No  straining  is 
seen  if  the  swabbing  is  done  thoroughly  and  there  is 
no  dribbling  of  discharge  for  days  afterward  as  occurs 
usually  without  swabbing. 

In  neglected  cases  which  show  signs  of  puerperal 
infection  much  good  comes  from  the  use  of  polyvalent 
bacterins.  In  fact,  it  is  good  policy  and  evidences 
sound  judgment,  to  administer  a  full  dose  of  bacterins 
in  every  case  of  retained  after-birth. 

Latent,  Imbedded  Foreign  Bodies. 

space  is  devoted  to  this  subject  only  for  the  pur- 
pose of  emphasizing  the  diagnosis  of  such  conditions 
as  result  from  foreign  bodies  remaining  deeply  im- 
bedded in  tissue. 

Whenever  a  tumefied  area  in  the  soft  tissues  con- 
tinues to  discharge  indefinitely,  healing  up  for  a  short 
time  and  then  breaking  out  again,  it  is  safe  to  assume 
that  a  foreign  body  of  some  sort  is  present.  Radical 
surgical  intervention  is  then  indicated  and  free,  bold 
incision  into  the  enlargement  will  usually  reveal  the 
causative  agent,  often  a  small  piece  of  wood. 

These  conditions  nearly  always  come  in  the  parts 
where  heavy  muscles  predominate.  Allowance  must 
be  made  for  thecal  abscesses  in  regions  where  bursae 
exist,  and  it  must  also  be  remembered  that  in  the  loca- 
tions of  the  various  groups  of  lymphatic  glands  a  sup- 
purative condition  may  occur  resembling  one  due  to  a 


80  SPECIAL  VETERINARY  THERAPY 

foreign  body.  However,  in  the  case  of  foreign  bodies 
the  discharge  is  less  of  the  nature  of  pus  and  is 
sanguinolent  in  character,  almost  a  **bloody  water/* 
as  the  client  usually  expresses  it. 


Botryomycosis. 


This  is  a  condition  which  is  very  troublesome  in 
the  southern  half  of  the  United  States.  It  occurs  to 
a  certain  extent  in  the  north  also  but  not  so  exten- 
sively nor  is  it  so  virulent  as  it  is  in  the  south,  where 
it  has  assumed  such  proportions  and  presents  such 
grave  problems  that  I  believe  it  is  only  a  question  of 
time  when  it  will  require  rigid  quarantine  regulations 
for  its  control  and  eradication. 

From  an  experience  with  this  condition  in  Texas, 
Oklahoma,  Arkansas,  New  Mexico  and  Old  Mexico, 
covering  a  period  of  nearly  six  years,  I  am  convinced 
that  we  have  in  veterinary  medicine  no  other  single 
infection  which  can  appear  in  as  great  a  variety  of 
forms,  which  attacks  as  great  a  variety  of  tissues  and 
which  presents  such  tenacity  of  life. 

Veterinarians  in  the  south  have  observed  botr}^- 
omycotic  infection  of  nearly  every  organ  in  the  body. 
In  certain  localities,  the  most  trivial  injuries,  such  as 
abrasions  from  interfering,  chafes  from  the  harness 
and  other  minor  hurts  develop  into  most  troublesome 
sores  as  a  result  of  this  infection.  The  slightest 
wound  should  not  be  neglected  in  these  regions. 

I  have  seen  valuable  stallions  made  worthless  for 
breeding  purposes  as  a  result  of  botryomycotic  infec- 
tion of  the  sheath  and  penis,  the  organ  developing  on 
the   glands   a   cauliflower-like   growth   the    size   of   a 

81 


S2  SPECIAL  VETERINARY  THERAPY 

cocoanut.  No  tissue  (with  the  possible  exception  of 
bone)  is  resistant  to  the  infection. 

A  very  common  form  occurs  in  the  lower  corner  of 
the  eyelids  with  the  formation  of  great  quantities  of 
the  typical  granules  in  and  around  the  lacrymal  sack 
and  at  times  extending  down  the  lacrymal  duct.  In 
this  location  the  infection  is  usually  handled  success- 
fully by  careful  and  thorough  removal  of  the  granules 
with  a  very  small  eye  curette  and  the  subsequent  treat- 
ment consisting  of  daily  application  of  a  mild  oint- 
ment of  yellow  oxide  of  mercury.  Two  or  three  cur- 
ettements  may  be  necessary. 

In  all  other  parts  of  the  body  this  disease  is  very 
resistant  to  treatment.  The  tendency  is  towards  the 
rapid  and  extensive  formation  of  fibrous  tissue,  which 
in  advanced  cases  becomes  almost  cartilaginous  in 
consistency.  Whether  this  is  the  direct  result  of  the 
infection  or  whether  it  is  an  effort  on  the  part  of  the 
tissues  to  wall  off  the  invading  organism  I  do  not 
know.  At  any  rate,  this  development  takes  place  very 
rapidly  and  causes  the  formation  of  a  tumor  in  a  short 
time.  The  surface  of  this  tumor  usually  remains  bare 
and  raw  and  the  characteristic  granules  or  small  ''grav- 
els" can  be  plainly  seen.  If  the  tumor  is  incised  they 
will  be  seen  to  extend  in  every  direction  and  frequent- 
ly some  of  these  granules  are  found  in  apparently 
healthy  tissue  entirely  outside  the  borders  of  the 
tumor. 

The  surface  of  the  tumor  is  kept  raw  by  almost  con- 
stant rubbing  on  the  part  of  the  horse.  Itching  seems 
to  be  all  but  intolerable  and  if  the  lesion  is  in  a  loca- 


BOTRYOMYCOSIS  S3 

tion  which  can  be  reached  with  the  teeth  the  animal 
is  constantly  gnawing  it. 

The  infection  is  undoubtedly  carried  by  flies.  I 
once  noted  on  the  postmortem  examination  of  a  horse 
that  had  died  as  the  result  of  prolonged  colic,  a  botry- 
omycotic  enlargement  of  all  the  mesenteric  glands. 
The  glands  had  become  enlarged  to  the  size  of  hen 
eggs  and  contained  throughout  the  hypertrophied  tex- 
ture numerous  characteristic  granules. 

During  cool  weather  the  symptoms  partially  sub- 
side and  if  the  winter  is  cold  enough  and  is  not  too 
short,  some  cases  apparently  heal  over  nicely.  iVs 
soon  as  warm  weather  returns  however,  the  infection 
becomes  active  again  and  the  disease  progresses  rap- 
idly. From  this  the  disease  has  probably  received  the 
common  name  of  ''summer  sore."  Also  for  this  rea- 
son, undoubtedly,  the  north  has  but  little  trouble  with 
this  infection,  the  winters  being  too  severe  and  too 
long  for  the  favorable  growth  of  the  infective  organ- 
ism. 

To  the  practitioner  who  has  had  little  or  no  experi- 
ence with  this  infection  it  would  appear  a  very  simple 
matter  to  excise  the  entire  growth.  Those  veterinar- 
ians who  know  this  condition  can  testify  to  the  futility 
of  this  procedure.  Though  the  dissection  be  ever  so 
thorough,  a  cure  rarely  follows.  This  is  no  doubt  due 
to  the  presence  of  some  of  the  botryomyces  in  tissue 
not  involved  in  the  tumor  and  would  be  a  point  in 
favor  of  the  theory  that  the  formation  of  fibrous  tissue 
is  due  to  an  effort  on  the  part  of  the  system  to  wall 


84  SPECIAL  VETERINARY  THERAPY 

off  the  infection  and  not  to  the  direct  action  of  the 
botryomyces. 

Another  obstacle  to  surgical  removal  of  these  tum- 
ors lies  in  the  fact  that  just  as  often  as  not,  they  are 
located  in  and  involve  parts  of  the  anatomy  where  ex- 
tensive dissection  is  out  of  the  question.  For  these 
reasons  surgical  removal  is  not  practical,  although, 
theoretically,  it  may  be  the  ideal  procedure. 

A  discussion  of  the  various  medical  and  chemical 
agents  which  have  been  resorted  to  in  the  treatment  of 
this  condition  would  make  an  endless  volume  and 
would  lead  to  no  satisfaction. 

There  is  a  fine  field  for  research  in  this  disease  and 
a  good,  reliable  treatment  is  yet  to  be  worked  out.  A 
better  understanding  of  the  condition  from  a  stand- 
point of  pathology  and  bacteriology  is  essential. 

In  1907,  Dr.  Frank  Thatcher,  then  city  bacteriolo- 
gist of  El  Paso,  Texas,  isolated  a  foreign  bacillus  from 
lesions  of  botryomycosis.  The  bacillus  was  anaerobic 
and  resembled  tubercle  bacilli  morphologically.  A 
bacterin  was  made  and  used  with  some  success,  after 
which  the  investigations  were  dropped. 

The  best  results  in  my  cases  were  obtained  with  a 
"cancer-paste"  which  is  quite  generally  used  by  veter- 
inarians in  the  south.  The  active  principle  in  this 
paste  is  cobalt  and  it  is  usually  made  as  follows : 

Pulverized   Sanguinaria 5  ij 

Zinc   Chloride ^  ss 

Powdered  Cobalt 3  i 

This  is  made  into  a  paste  with  water,  requiring 
much  grinding  in  a  mortar  before  it  becomes  smooth. 


BOTRYOMYCOSIS  8S 

Some  veterinarians  add  cocaine  to  make  it  painless 
when  applied. 

When  the  paste  is  prepared  it  is  spread  on  a  thin 
layer  of  cotton,  the  raw  surface  of  the  tumor  is 
swabbed  thoroughly  dry  with  absorbent  cotton,  and 
the  thin  layer  of  cotton  containing  the  paste  is  then 
snugly  pressed  onto  the  surface.  It  dries  and  adheres 
firmly  in  a  few  hours,  during  which  time  the  horse 
must  be  prevented  from  biting  or  rubbing  the  part. 
When  the  paste  once  becomes  fixed  on  the  tumor  all 
itching  seems  to  stop  at  once  and  in  a  few  days  the 
tumor  decreases  considerably  in  size  and  assumes  an 
appearance  of  general  improvement. 

After  the  lapse  of  ten  days  or  two  weeks  the  entire 
mass  drops  out,  leaving  a  healthy,  granulating  cavity 
which  is  then  treated  with  astringent  lotions  until 
healing  is  complete.  This  treatment  gives  fairly  uni- 
form, but,  by  no  means  universally,  successful  results. 

Every  observation  of  this  condition  points  to  best 
results  with  agents  of  alkaline  re-action.  Acids  are 
generally  not  favorably  received  in  this  affection. 

This  disease  is  of  such  a  character  and  is  so  gen- 
eral throughout  the  south  that  it  is  a  worthy  subject 
for  investigation  by  our  research  men.  Much  appre- 
ciation awaits  him  who  elaborates  a  uniformly  suc- 
cessful treatment  for  this  disease. 


Chronic  Edema  of  the  Hind  Extrem- 
ities—Stocking. 

Persistent  stocking  in  the  hind  legs  from  the  hock 
down  is  a  somewhat  common  condition.  Close  ob- 
servation will  disclose  the  fact  that  geldings  are  most 
often  affected. 

Stocking  affects  mares  as  well  in  conjunction  with 
various  skin  diseases,  such  as  scratches  for  instance. 
It  is  chiefly  in  geldings  that  stocking  occurs  as  a 
clinical  entity  without  apparent  lesions  of  any  kind 
on  the  extremities  involved. 

In  most  of  these  cases  either  an  excessive  amount 
of  scar  tissue  resulting  from  castration  is  present  or  a 
scirrhus  cord  is  present  or  beginning  to  form. 

If  the  veterinarian  will  carefully  examine  the 
region  about  the  scrotal  fold  in  geldings  of  any  age 
whose  hind  extermities  "stock"  habitually,  he  will  in- 
variably discover  one  of  the  above  mentioned  condi- 
tions. If  it  is  merely  a  case  of  a  pad  of  dense  scar 
tissue  with  surrounding  adhesions,  iodide  of  potash 
will  give  excellent  results.  Even  in  some  small  scirr- 
hus cords,  prolonged  administration  of  iodide  of  potas- 
sium will  terminate  the  trouble.  In  scirrhus  cords  of 
larger  dimensions,  surgical  removal  is  the  only  re- 
course. However,  in  all  cases  a  good  course  of  potas- 
sium iodide  should  be  tried  first  as  frequently  it  gives 
results  when  least  expected. 


Pulmonary  Emphysema— "Heaves." 

Common  as  this  condition  is  in  veterinary  patients 
it  is  doubtful  whether  there  is  a  condition  which  is 
treated  in  a  more  careless  and  empirical  manner. 

In  the  first  place  it  is  customary  with  most  prac- 
titioners to  treat  all  dyspnea  of  a  chronic  nature  re- 
ferrable  to  the  thoracic  cavity  as  pulmonary  emphy- 
sema. It  is  chiefly  for  this  reason  that  the  various 
treatments  in  vogue  for  the  relief  of  this  condition  are 
so  uncertain  in  results. 

Unless  the  patient  in  question  is  under  observation 
for  a  long  time  or,  unless  an  intelligent  history  of  the 
case  can  be  obtained,  pulmonary  emphysema  can  be 
diagnosed  only  by  careful  auscultation  and  percussion ; 
a  proceeding  to  which  the  general  practitioner  resorts 
but  rarely.  A  diagnosis  arrived  at  by  mere  inspection 
of  the  inspiratory  movements  and  expiratory  spasm  of 
the  abdominal  muscles  is  of  no  value  from  a  stand- 
point of  treatment. 

True  pulmonary  emphysema  is,  of  course,  incur- 
able. Intelligent  treatment,  however,  can  do  much 
towards  enhancing  the  value  of  the  patient  as  a  serv- 
iceable animal.  More  than  this,  our  knowledge  of  the 
pathology  of  the  disease  forbids  us  to  expect.  And 
in  this  lies  the  point  of  value  in  careful  examination. 

Knowing  that  in  a  case  of  true  pulmonary  emphy- 
sema we  can  give  our  client  little  or  no  encouragement 
of  cure,  it  is  little  short  of  criminal  from  a  professional 
standpoint  to  err,  through  fault  of  a  superficial  exam- 

87 


S8  SPECIAL  VETERINARY  THERAPY 

ination,  to  the  extent  of  confounding  a  possibly  cure- 
able  condition  with  this  one. 

In  pulmonary  emphysema  such  structural  changes 
have  taken  place  in  the  lung  that  it  would  be  evidence 
of  inferior  mental  calibre  to  attempt  their  repair  by 
medicinal  means.  Likewise,  surgical  interference  is 
out  of  the  question,  although  an  operation  of  section 
of  ribs  has  been  used  for  relief  of  the  dyspnea  induced 
by  pulmonary  emphysema. 

In  the  treatment  of  the  dyspnea  from  pulmonary 
emphysema,  no  set  rule  should  be  adhered  to.  Al- 
though the  pathology  is  identical  in  all  cases  the  res- 
ponse to  various  forms  of  treatment  varies  greatly. 
Many  cases  can  be  much  improved  with  ordinary  anti- 
acid  treatment,  such  as  bicarbonate  of  sodium,  sodium 
borate  and  similar  salts.  In  other  cases  arsenic  works 
wonders. 

A  valuable  drug  in  this  disease  which  has  not  come 
much  into  use  among  veterinarians  in  America,  is 
grindelia.  The  fluid  extract  is  the  most  convenient  form 
and  the  effect  is  usually  very  gratifying. 

It  is  always  well  to  begin  with  a  small  dose  which 
should  be  gradually  increased  until  the  desired  effect  is 
obtained. 

Arecoline  has  been  recommended  as  a  diagnostic 
agent  for  pulmonary  emphysema,  but  is  unreliable  be- 
cause it  has  the  same  effect  in  cases  of  functional  neu- 
rosis such  as  asthma  and  bronchio-spasm,  that  it  has 
on  pulmonary  emphysema. 

It  is  doubtful  whether  definite  diagnosis  is  possible 
by  any  other  means  than  auscultation  and  percussion. 


Neglected  Medicinal  Agents  in 
Veterinary  Medicine. 

Compound  Tincture  of  Benzoin  :  (Friars  Balsam). 

Compound  tincture  of  benzoin  is  of  much  value  in 
treating  various  forms  of  stomatitis  and  such  condi- 
tions as  ulcers  on  the  oral  and  nasal  mucous  mem- 
branes, alveolar  abscess,  gingivitis  and  lacerations  of 
the  tongue.  For  these  affections  it  is  applied  occa- 
sionally during  the  day  full  strength  with  a  cotton 
swab  or  camel-hair  brush. 

Shaken  up  with  equal  parts  of  glycerine  the  com- 
pound tincture  of  benzoin  is  a  good  application  for 
cracked  teats.     It  should  be  applied  after  milking. 

It  finds  its  best  field,  however,  in  affections  of  the 
mucous  membranes,  especially  in  the  mouth. 

Oil  of  Cajuput: 

In  parasitic  skin  diseases  we  can  use  nothing  bet- 
ter than  this  volatile  oil. 

In  certain  forms  of  intestinal  fermentation  it  is  a 
good  remedy,  for  instance  in  such  as  result  from  the 
ingestion  of  green  food. 

As  a  fly  repellant  on  the  surface  of  wounds  it  is 
excellent  when  suspended  in  heavier  oils.  In  liniments 
for  rheumatic  pains,  it  also  has  a  place. 

Hexamethylenamine. 

This  drug  can  be  absolutely  depended  upon  to  pre- 
vent infectious  cerebro-spinal  meningitis.     It  is  quite 

S9 


90  SPECIAL  VETERINARY  THERAPY 

soluble  and  in  solution  almost  tasteless  so  that  it  can 
be  given  in  the  drinking  water.  For  horses,  two 
drams,  three  times  daily  in  drinking  water  is  a  sure 
preventive  of  the  above  disease. 

It  is  also  very  useful  in  cystitis,  urethritis  and 
arthritis,  besides  possessing  valuable  properties  as  an 
intestinal  antiseptic.  It  has  been  held  that  it  must  be 
given  in  conjunction  with  an  acid.  Clinically  this  has 
not  been  found  necessary. 

Passiflora  Incarnata. 

The  fluid  extract  of  this  drug  is  of  real  worth  in 
veterinary  practice.  In  all  conditions  other  than  sur- 
gical operations,  in  which  it  is  desirable  to  relieve 
pain,  passiflora  stands  first  in  the  list  of  drugs. 

Its  action  is  more  one  of  calm  sedation  than  of 
hypnosis  or  narcosis  and  this  effect  may  be  kept  up 
indefinitely  by  proper  dosage  without  any  bad  after- 
efifects  whatever. 

An  ounce  dose  can  be  given  every  hour  if  necessary 
until  the  physiological  effect  is  produced ;  then  its 
administration  less  often  will  maintain  this  effect.  In 
conditions  in  which  opium  or  morphine  are  contra-in- 
dicated, passiflora  may  be  used  effectually. 

Mercurials  : 

Of  these  the  most  serviceable  in  veterinary  prac- 
tice is  the  proto-iodide.  It  has  real  value  in  general 
infections  and  glandular  diseases  in  from  two  to  three 
grain  doses,  especially  when  chronic. 

In  the  secondary  pustular  and  suppurative  condi- 
tions of  canine  distemper  doses  of  one-sixteenth  grain 
work  wonders. 


NEGLECTEiD  MEDICINAL  AGENTS.  91 

In  the  enlargement  of  the  parotid  gland  frequently 
seen  after  quinzy  this  drug  gives  good  results. 

The  hardness  remaining  in  udders  after  mastitis 
yields  to  a  course  of  treatment  within  a  few  weeks' 
time. 

Potassium  Dichromate  : 

Besides  its  specific  action  in  infectious  entero-hep- 
atitis  in  fowls,  this  salt  should  not  be  forgotten  in 
chronic  affections  of  the  upper  air  passages.  In  two 
to  four  grain  doses  in  solution  it  can  be  depended  upon 
to  stop  coughs  and  catarrh  which  follow  laryngitis, 
pharyngitis  and  influenza. 

Locally,  in  five  per  cent  watery  solution,  it  hastens 
the  disappearance  of  swelling  in  lymphangitis  and 
local  glandular  swellings,  if  applied  with  a  brush  twice 
daily.  In  powder  it  is  a  good  packing  for  thrush,  bet- 
ter than  calomel  and  much  cheaper. 

Stovaine. 

Of  all  local  anesthetics  stovaine  takes  the  prefer- 
ence in  veterinary  practice.  It  is  practically  non-toxic 
for  our  patients  and  immense  quantities  can  be  used  in 
solution  without  producing  the  untoward  effects  of 
cocaine. 

The  anesthesia  from  stovaine  lasts  about  three 
hours  and  is  just  as  complete  as  cocaine  anesthesia. 
Stovaine  is  cheaper  than  cocaine  and  solutions  of  it 
do  not  decompose  as  quickly  as  cocaine  solutions. 

Care  must  be  taken  to  keep  it  from  contamination 
with  alkalies.     Even  a  trace  of  alkali  makes  it  inert. 

Chromium  Trioxide: 

This  is  an  ideal  agent  in  two  per  cent  solutions  for 


92  SPECIAL  VETERINARY  THERAPY 

use  in  abscess  cavities.  The  same  strength  solution 
gives  fine  results  in  the  treatment  of  v^arts  if  applied 
with  a  brush  once  or  twice  a  day. 

Cotton  saturated  with  a  five  to  ten  per  cent  solu- 
tion makes  a  good  swab  for  foul  smelling  sores,  ulcers 
or  wounds. 

For  thrush,  cotton  saturated  with  a  ten  per  cent 
solution  makes  a  good  packing. 


I  Stock  Colic  Mixtures.* 

All,  I  think,  will  acknowledge  that  colic  in  its  gen- 
eric sense  cannot  be  properly  nor  scientifically  treated 
by  stock  mixtures  which  of  necessity  must  be  of  the 
"shot-gun"  variety.  However,  we  are  forced  to  sup- 
ly  some  of  our  clients  with  a  '*colic  remedy"  for  vari- 
ous and  obvious  reasons,  one  of  which  is  to  prevent 
them  from  using  quack  nostrums  and  another  is  to 
save  ourselves  from  being  called  out  at  night. 

This  being  so,  study  the  question  closely  and  omit 
drugs  like  opium,  morphine,  cannabis  indica  and  hys- 
ocyamus,  which  are  non-curative,  and  will  mask  the 
symptoms  should  the  case  later  demand  your  personal 
attention.  In  addition,  they  will  retard  the  effects  of 
the  quick-acting  cathartics,  should  they  be  given. 

Anodynes  and  antispasmodics  which  may  be  sub- 
stituted for  the  above  and  which  do  not  have  their 
objectionabHie  features  are  belladonna,  stramonium, 
acetanilid  and  oil  of  turpentine. 

It  is  best,  on  stock-mixture  labels,  to  advise  that 
not  more  than  two  doses  be  given,  and  that  upon  the 
failure  of  the  second  dose  the  doctor  be  called.  This 
limitation  of  the  number  of  doses  is  imperative  if  they 
contain  any  of  the  poisonous  drugs. 


•This  and  the  following  article  were  not  Included  In  Dr.  Steffen's 
manuscript.  This  discussion  is  excerpted  from  an  article  on  the 
"Medicinal  Treatment  of  Colics,"  by  E.  L.  Quitman,  published  in  "Colics 
and  Their  Treatment"  by  the  Ameriean  Journal  oj  Veterinarv  Medicine,  Bva.n- 
ston,     Illinois. 

93 


94  SPECIAL  VETERINARY  THERAPY 

When  medicine  is  furnished  to  clients  living  many 
miles  from  the  office,  where  many  doses  may  be  admin- 
istered, it  is  doubly  advisable  to  omit  poisonous  drugs 
from  the  mixture.  In  fact,  it  is  advisable  to  omit 
these  even  in  city  practice  where  the  ignorant  horse- 
men will  not  read  or  obey  even  the  most  explicit 
directions. 

The  suggestions  for  the  possible  use  of  belledonna 
and  stramonium  are  made  more  for  administration  by 
the  veterinarian  than  for  use  in  stock  colic  mixtures. 
For  a  stock  colic  mixture  which  is  as  nearly  harmless 
as  any  that  can  be  made,  and  still  be  of  value,  the  fol- 
lowing is  suggested: 

l^ 

Acetanilidi   Puly 3  ij  to  iij 

Ol.  Menthaw    Piperitae 3  ij 

Ol.  Terebinthinae. 
Athens. 

Tr.   Zingiberis aa  5  j  to  ij 

Ac.    Salicylici 3  iij  to  iv 

Ol.   Lini q,  s.  ad.  S  xij 

M.  Sig. — Give  at  one  dose  (repeat  in  an 
hour  if  necessary). 
The  acetanilid  is  used  on  account  of  its  being  a 

non-constipating  anodyne.     One  that  will  not  retard 

the  action  of  eserine  or  arecoline,  and  has  a  beneficial 

influence  in  congestive  conditions  of  the  bowels. 

Tincture  of  ginger  is  preferable  to  tincture  of  cap- 
sicum because  the  latter  is  constipating. 

Spirits  of  nitrous  ether  may  be  used  in  place  of  the 
ether  if  desired. 


Castration  of  Pigs  Having  Scrotal 
Hernia.* 

Cases  of  scrotal  hernia  in  pigs  or  a  rupture  as  the 
farmer  calls  it  is  a  markedly  hereditary  condition.  On 
some  farms  from  year  to  year  there  are  numerous 
cases  of  this  kind  among  the  pigs ;  on  other  farms  this 
condition  is  scarcely  known,  its  presence  or  absence 
depending,  as  may  easily  be  demonstrated,  upon- 
heredity. 

Some  farmers  castrate  these  pigs  as  readily  as  they; 
castrate  their  ordinary  boar  pigs,  but  a  great  man/ 
others  find  the  operation  difficult  or  are  entirely  un- 
able to  perform  it  and  with  them  such  pigs  are  usually 
destroyed  as  soon  as  the  hernia  is  noted  or  the  condi" 
tion  is  allowed  to  grow  worse  until  death  results  from 
strangulation  of  the  intestine  or  from  a  traumatism 
to  the  scrotum. 

The  value  of  the  animal  is  so  slight  that  unless 
there  is  a  considerable  number  of  these  ruptured  pigs 
in  the  same  brood  or  there  be  a  very  large  number  of 
hogs  raised  upon  the  place,  this  work  can  never 
amount  to  much  financially,  but  frequently  when  the 
veterinarian  is  called  to  a  farm  for  other  work  he  is 
asked  to  castrate  one  or  two  or  three  of  these  pigs. 

There  is  scarcely  an  operation  that  is  more  simple 


•Reprinted  from   "Springtime  Surgery,"  published  by   the    Ameruan 
Jomnei  at  Veterinary  Medicine,  Bvanst«B.  IlL 

96 


96  SPECIAL  VETERINARY  THERAPY 

than  this  one  and  yet  it  is  one  with  which  some  veter- 
inarians, because  of  their  faulty  technic,  have  experi- 
enced not  a  little  difficulty.  To  throw  the  animal,  hold 
him  on  his  side  and  attempt  to  castrate  him,  as  is  done 
in  ordinary  castration  is  to  bring  on  such  forcible  ex- 
trustion  of  the  intestines  that  castration  cannot  be 
accomplished  successfully,  but  if  the  pig  be  held  up  by 
his  hind  legs  with  his  back  to  the  holder  and  with  his 
forefeet  just  touching  the  ground  and  possibly  his 
neck  between  the  ankles  of  the  man  holding  him  the 
intestines  will  return  to  the  abdominal  cavity  of  their 
own  accord,  or  with  slight  manipulation  and  while 
held  in  this  position  castration  is  an  exceedingly  sim- 
ple operation.  Observe  the  usual  aseptic  precau- 
tions advisable  in  all  minor  surgery.  If  the  inguinal 
aperture  in  the  abdominal  wall  is  very  large  it  may  be 
necessary  to  hold  the  testicle  through  the  scrotum  to 
prevent  its  return  into  the  abdominal  cavity  along 
with  the  intestines.  Should  the  testicle  return  to  the 
abdominal  cavity,  lower  the  animal  until  the  testicle 
again  returns  to  the  scrotum. 

Holding  the  testicle  between  the  thumb  and  fing- 
ers as  for  ordinary  castration  cut  through  the  skin  and 
•dartos  as  for  the  covered  operation.  Strip  the  cellular 
tissue  from  the  tunica  vaginalis  as  close  up  to  the  in- 
ternal inguinal  ring  as  it  is  possible  to  get.  Then  place 
a  ligature  very  tightly  around  the  tunica  vaginalis  or 
sac  including  the  cord,  vas  deferens,  the  arteries,  veins 
and  nerves,  first  making  certain  no  portion  of  the  in- 
testine is  included  in  the  ligature  and  that  it  is  close 
enough  to  the  internal  inguinal  ring  to  prevent  subse- 


CASTRATION  OF  PIGS.  97 

quent  saculation  and  a  further  escape  of  the  intestine 
from  the  abdominal  cavity.  The  ligation  may  be  made 
with  any  stout  cord,  that  has  been  rendered  aseptic 
and  the  ends  of  it  should  be  left  long  enough  to  hang 
slightly  out  of  the  scrotal  wound.  Cut  off  the  cord 
with  its  covering  membrane  just  back  of  the  ligation. 
It  is  a  serious  mistake  to  incise  the  tunica  vaginalis 
before  the  cord  is  ligated.  Remove  the  other  testicle 
and  the  operation  is  complete. 

The  peritoneal  surfaces  of  the  tunica  vaginalis  will 
adhere  in  a  few  hours  and  in  a  few  days  that  portion 
of  the  tunic  below  the  ligation  will  slough  off  and  come 
away  together  with  the  string  with  which  it  is  tied.  It 
is  necessary  to  make  the  wound  rather  low  so  that 
drainage  may  be  good.  The  entire  operation  requires 
less  than  one-half  the  time  it  takes  to  describe  it  and 
the  mortality  is  practically  nil. 

It  may  be  beneath  the  dignity  of  some  veterinar- 
ians to  charge  a  fee  for  this  operation  but  the  opera- 
tion is  not  too  insignificant  to  be  appreciated  by  the 
owner  and  it  is  well  worth  while  viewed  from  any 
angle.  If  undertaken  at  all  of  course  it  should  be  well 
done. 


Webster  Family  Library  of  Veterinary  IVIedicine 
Cummings  School  of  Veterinary  Medicine  at 
Tufts  University 


